Glycemic and Blood Pressure Control in Type 2 Diabetes Mellitus: Disability Costs Covered by Social Security, Evidence From Mexico.

Abstract

Objectives: To analyze the difference in type 2 diabetes mellitus (T2DM) disability costs subsidized by the Mexican Social Security Institute for employees with normoglycemia and normotension (n = 547 488) from the 2016 to 2018 National Census of Workers with T2DM registered with the Mexican Social Security Institute.

Methods: We tested whether the control of these indicators reduced disability payments at work, the costs of subsidy distribution in different salary groups, and their associated diseases.

Results: Differences (P < .001) emerged in disability leave costs for employees who did not control their blood pressure. Highest-earning employees had the highest costs compared with lower-earning workers. The most frequent subsidized diseases included gastric problems, lower-back disorders, and respiratory infections.

Conclusions: Based on data from all the insured employees with T2DM registered in the National Census, this study enjoyed strong internal validity, indicating that failure to control blood pressure levels correlated with higher costs. The highest costs resulted from noncomplicated diseases. Employees earning higher incomes accounted for the highest costs, suggesting the existence of unequal subsidy conditions.