The association of unemployment with glucose metabolism: a systematic review and meta-analysis

Abstract

Objectives: Unemployment has been linked with poor health. We hypothesized that being unemployed is associated with disorders of glucose metabolism and performed a systematic review and meta-analysis of the literature to ascertain the relationship. Methods: We searched the databases of Scopus, Medline Ovid and Web of Science for population-based original studies for past 20 years. Random effects meta-analyses were used to estimate odds ratios (OR) with 95% confidence intervals (CI) for prediabetes and type 2 diabetes among the unemployed as compared to those employed, separately for men and women when possible. Results: Out of 981 articles found, 12 articles were included in the systematic review and eight articles in the meta-analyses. Unemployment was associated with 1.6-fold odds for prediabetes (OR 1.58; 95% CI 1.07–2.35), and 1.7-fold odds for type 2 diabetes (OR 1.72; 95% CI 1.14–2.58) in the total sample. The corresponding associations for type 2 diabetes were also found stratified for men (OR 1.53; 95% CI 1.47–1.60) and women (OR 1.60; 95% CI 1.33–1.92). Conclusions: Unemployment is associated with prediabetes and type 2 diabetes, global concerns of public health with potential for prevention.