T2D’s productivity costs substantial in HK, particularly in young adults and women

Type 2 diabetes (T2D) is associated with substantial reductions in productivity-adjusted life years (PALYs) and indirect economic costs in the working-age population in Hong Kong, particularly among those 20–24 years of age and in women, researchers from the Chinese University of Hong Kong (CUHK) have reported.

In a population-based modelling study, the CUHK Diabetes Research Group simulated the economic impact of T2D using data of 257,280 individuals aged 20–64 years with a diagnosis of T2D in 2019 in Hong Kong. PALYs – a novel health metric – was used to quantify diabetes-related productivity loss due to absenteeism, presenteeism, labour force dropout and premature mortality until the retirement age of 65 years. The PALY loss was translated into gross domestic product (GDP) loss in Hong Kong. [Lancet Reg Health West Pac 2025;doi: 10.1016/j.lanwpc.2025.101585]

In 2019, a total of 257,280 working-age individuals in Hong Kong had a diagnosis of T2D. This accounted for 6.3 percent of men (n=139,610) and 4.2 percent of women (n=117,670) in the working-age population.

Until the retirement age of 65 years, T2D was associated with a 17.0 percent reduction in PALYs in men and a 27.8 percent reduction in PALYs in women. This was equivalent to 1.0 PALY lost per man and 1.1 PALYs lost per woman.

“The total PALYs lost resulted in an estimated GDP loss of USD 15.3 billion [HKD 119 billion] in men and USD 14.5 billion [HKD 113 billion] in women,” the researchers reported.

“Younger individuals with diabetes lost significantly more PALYs per person than older individuals,” the researchers highlighted. “Men and women aged 20–24 years lost 3.9 and 5.0 PALYs per person due to diabetes, respectively, compared with 0.3 PALYs lost per person in both men and women aged 60–64 years.”

In men and women aged 20–24 years with T2D, the estimated per-person GDP loss was USD 604,609 (HKD 4.75 million) and USD 714,609 (HKD 5.61 million), respectively, compared with USD 23,694 (HKD 185,978) and USD 24,908 (HKD 195,528), respectively, in their counterparts aged 60–64 years.

“Labour force dropout was the major contributor to GDP loss in both men [69.2 percent] and women [87.0 percent], followed by premature mortality [21.4 and 6.8 percent, respectively], absenteeism [7.8 and 5.0 percent, respectively], and presenteeism [1.6 and 1.0 percent, respectively],” the researchers noted.

“Productivity loss is a frequently overlooked economic consequence of chronic illness such as diabetes, as most attention has traditionally focused on direct healthcare costs,” said senior author Professor Andrea Luk of the Department of Medicine and Therapeutics, CUHK. “Our findings shed light on the broader societal costs associated with diabetes and reinforce the need to prioritize diabetes prevention in our workforce.”

The disproportionately higher impact on younger individuals and women revealed in the current study highlights the need for targeted intervention to address these disparities.

“Young-onset diabetes is a highly complex condition with genetic and non-genetic causes,” said Professor Juliana Chan of the Department of Medicine and Therapeutics, CUHK. “Population surveys in Hong Kong showed that a substantial proportion of young people with diabetes remained undiagnosed, highlighting the need to raise awareness and improve early detection.”