Work productivity and psychological well-being in patients affected by type 1 diabetes mellitus

Type 1 diabetes mellitus (T1D) is a lifelong autoimmune condition that, when diagnosed during childhood or adolescence, may influence educational attainment, employment trajectories, and occupational functioning in adulthood. This observational cross-sectional study, conducted between June and September 2024 at the "Federico II" University Hospital in Naples, Italy, assessed work ability, work productivity, activity impairment, and psychological well-being in 70 adults with T1D. Sociodemographic, clinical, and occupational data were collected through structured interviews and medical record review. Work ability was evaluated using the Work Ability Index (WAI), productivity and activity impairment using the Work Productivity and Activity Impairment questionnaire (WPAI), and psychological well-being using the Psychological General Well-Being Index (PGWBI). Overall, 49% of participants were unemployed. Among employed individuals, work ability was generally preserved, with 72% reporting good or excellent WAI scores, although WAI declined significantly with age (p = 0.040). WPAI results showed low absenteeism (5.5%) but relevant presenteeism (26.7%) and activity impairment (42.7%). Activity impairment was higher among unemployed than employed participants (61.2% vs. 25.3%; p < 0.0001). Mean PGWBI scores indicated preserved psychological well-being (66.8 ± 20.3) but declined with increasing age (p = 0.001) and unemployment (p = 0.003). Higher PGWBI scores correlated with greater work ability (rs = 0.72, p < 0.0001) and lower activity impairment (rs = -0.79, p < 0.0001). Glycated hemoglobin, body mass index, occupational category, and insulin delivery technology were not significantly associated with outcomes. Overall, age and employment status emerged as relevant correlates of functional and psychological outcomes. These findings support integrated occupational strategies beyond glycemic control and appropriate targeted workplace accommodations.