Population-level productivity-adjusted life years lost in individuals with type 2 diabetes in Hong Kong: a life table modelling studyResearch in context
Summary: Background: Type 2 diabetes has become increasingly prevalent in young populations who are in their prime working years. We estimated the population-level productivity-adjusted life years (PALYs) lost in the working-age population with type 2 diabetes in Hong Kong. Methods: We constructed...
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Elsevier
2025-06-01
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| Series: | The Lancet Regional Health. Western Pacific |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666606525001221 |
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| author | Hongjiang Wu Haobin Zhou Chuiguo Huang Aimin Yang Eric S.H. Lau Xinge Zhang Baoqi Fan Ronald C.W. Ma Alice P.S. Kong Elaine Chow Wing-Yee So Juliana N.M. Lui Juliana C.N. Chan Andrea O.Y. Luk |
| author_facet | Hongjiang Wu Haobin Zhou Chuiguo Huang Aimin Yang Eric S.H. Lau Xinge Zhang Baoqi Fan Ronald C.W. Ma Alice P.S. Kong Elaine Chow Wing-Yee So Juliana N.M. Lui Juliana C.N. Chan Andrea O.Y. Luk |
| author_sort | Hongjiang Wu |
| collection | DOAJ |
| description | Summary: Background: Type 2 diabetes has become increasingly prevalent in young populations who are in their prime working years. We estimated the population-level productivity-adjusted life years (PALYs) lost in the working-age population with type 2 diabetes in Hong Kong. Methods: We constructed life tables for individuals aged 20–64 years with type 2 diabetes, with simulated follow-up until retirement at 65 years. We then re-simulated the life tables for the same cohort with the hypothetical assumption that they did not have diabetes, adjusting for differences in mortality rates, labour force participation rates, and productivity. We calculated diabetes-related PALYs lost and assumed the cost of each PALY to be equivalent to the annual gross domestic product (GDP) per worker. Findings: In 2019, 6.3% (n = 139,610) of men and 4.2% of women (n = 117,670) of working age had diagnosed type 2 diabetes in Hong Kong. Over their working lifetime, diabetes was associated with a 17.0% (95% CIs: 16.9%, 17.1%) reduction in PALYs in men and 27.8% (95% CIs: 27.6%, 28.0%) in women, equivalent to 1.0 (95% CIs: 1.0, 1.0) and 1.1 (95% CIs: 1.1, 1.1) PALYs lost per man and woman, respectively. Younger individuals with diabetes experienced greater per-person PALYs lost than older individuals. Men and women aged 20–24 years lost 3.9 (95% CIs: 3.9, 3.9) and 5.0 (95% CIs: 5.0, 5.0) PALYs per person due to diabetes, compared to 0.3 (95% CIs: 0.3, 0.3) PALYs in both sexes aged 60–64 years. The total PALYs lost resulted in a GDP loss of USD 15.3 (95% CIs: 15.2, 15.4) billion in men and USD 14.5 (95% CIs: 14.4, 14.6) billion in women. Interpretation: Type 2 diabetes was associated with substantial reductions in PALYs and indirect economic costs in Hong Kong, with disproportionate impacts on women and younger populations. Targeted interventions are needed to address these disparities and mitigate the dual burden of health and economic consequences of diabetes. Funding: Direct Grant for Research from The Chinese University of Hong Kong. |
| format | Article |
| id | doaj-art-9ff4b829b78a425b9c823acf38a9ce7a |
| institution | OA Journals |
| issn | 2666-6065 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Elsevier |
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| series | The Lancet Regional Health. Western Pacific |
| spelling | doaj-art-9ff4b829b78a425b9c823acf38a9ce7a2025-08-20T02:05:13ZengElsevierThe Lancet Regional Health. Western Pacific2666-60652025-06-015910158510.1016/j.lanwpc.2025.101585Population-level productivity-adjusted life years lost in individuals with type 2 diabetes in Hong Kong: a life table modelling studyResearch in contextHongjiang Wu0Haobin Zhou1Chuiguo Huang2Aimin Yang3Eric S.H. Lau4Xinge Zhang5Baoqi Fan6Ronald C.W. Ma7Alice P.S. Kong8Elaine Chow9Wing-Yee So10Juliana N.M. Lui11Juliana C.N. Chan12Andrea O.Y. Luk13Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China; Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of ChinaThe First School of Clinical Medicine, Guangzhou Medical School, People's Republic of ChinaDepartment of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of ChinaDepartment of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China; Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of ChinaDepartment of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China; Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of ChinaDepartment of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of ChinaDepartment of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of ChinaDepartment of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China; Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China; Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of ChinaDepartment of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China; Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China; Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of ChinaDepartment of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of ChinaDepartment of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China; Hong Kong Hospital Authority, Hong Kong Special Administrative Region, People's Republic of ChinaDepartment of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China; Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of ChinaDepartment of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China; Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China; Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of ChinaDepartment of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China; Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China; Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China; Corresponding author. Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, 9/F Lui Che Woo Clinical Sciences Building, Shatin, New Territories, Hong Kong Special Administrative Region, People's Republic of China.Summary: Background: Type 2 diabetes has become increasingly prevalent in young populations who are in their prime working years. We estimated the population-level productivity-adjusted life years (PALYs) lost in the working-age population with type 2 diabetes in Hong Kong. Methods: We constructed life tables for individuals aged 20–64 years with type 2 diabetes, with simulated follow-up until retirement at 65 years. We then re-simulated the life tables for the same cohort with the hypothetical assumption that they did not have diabetes, adjusting for differences in mortality rates, labour force participation rates, and productivity. We calculated diabetes-related PALYs lost and assumed the cost of each PALY to be equivalent to the annual gross domestic product (GDP) per worker. Findings: In 2019, 6.3% (n = 139,610) of men and 4.2% of women (n = 117,670) of working age had diagnosed type 2 diabetes in Hong Kong. Over their working lifetime, diabetes was associated with a 17.0% (95% CIs: 16.9%, 17.1%) reduction in PALYs in men and 27.8% (95% CIs: 27.6%, 28.0%) in women, equivalent to 1.0 (95% CIs: 1.0, 1.0) and 1.1 (95% CIs: 1.1, 1.1) PALYs lost per man and woman, respectively. Younger individuals with diabetes experienced greater per-person PALYs lost than older individuals. Men and women aged 20–24 years lost 3.9 (95% CIs: 3.9, 3.9) and 5.0 (95% CIs: 5.0, 5.0) PALYs per person due to diabetes, compared to 0.3 (95% CIs: 0.3, 0.3) PALYs in both sexes aged 60–64 years. The total PALYs lost resulted in a GDP loss of USD 15.3 (95% CIs: 15.2, 15.4) billion in men and USD 14.5 (95% CIs: 14.4, 14.6) billion in women. Interpretation: Type 2 diabetes was associated with substantial reductions in PALYs and indirect economic costs in Hong Kong, with disproportionate impacts on women and younger populations. Targeted interventions are needed to address these disparities and mitigate the dual burden of health and economic consequences of diabetes. Funding: Direct Grant for Research from The Chinese University of Hong Kong.http://www.sciencedirect.com/science/article/pii/S2666606525001221DiabetesProductivity lossLife table |
| spellingShingle | Hongjiang Wu Haobin Zhou Chuiguo Huang Aimin Yang Eric S.H. Lau Xinge Zhang Baoqi Fan Ronald C.W. Ma Alice P.S. Kong Elaine Chow Wing-Yee So Juliana N.M. Lui Juliana C.N. Chan Andrea O.Y. Luk Population-level productivity-adjusted life years lost in individuals with type 2 diabetes in Hong Kong: a life table modelling studyResearch in context The Lancet Regional Health. Western Pacific Diabetes Productivity loss Life table |
| title | Population-level productivity-adjusted life years lost in individuals with type 2 diabetes in Hong Kong: a life table modelling studyResearch in context |
| title_full | Population-level productivity-adjusted life years lost in individuals with type 2 diabetes in Hong Kong: a life table modelling studyResearch in context |
| title_fullStr | Population-level productivity-adjusted life years lost in individuals with type 2 diabetes in Hong Kong: a life table modelling studyResearch in context |
| title_full_unstemmed | Population-level productivity-adjusted life years lost in individuals with type 2 diabetes in Hong Kong: a life table modelling studyResearch in context |
| title_short | Population-level productivity-adjusted life years lost in individuals with type 2 diabetes in Hong Kong: a life table modelling studyResearch in context |
| title_sort | population level productivity adjusted life years lost in individuals with type 2 diabetes in hong kong a life table modelling studyresearch in context |
| topic | Diabetes Productivity loss Life table |
| url | http://www.sciencedirect.com/science/article/pii/S2666606525001221 |
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