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

Int J Public Health. 2018 May;63(4):435-446. doi: 10.1007/s00038-017-1040-z. Epub 2017 Nov 23.


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.

Keywords: Glucose metabolism; Meta-analysis; Prediabetes; Systematic review; Type 2 diabetes; Unemployment.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Adult
  • Diabetes Mellitus, Type 2 / complications*
  • Diabetes Mellitus, Type 2 / psychology*
  • Employment / psychology*
  • Employment / statistics & numerical data
  • Female
  • Glucose / metabolism*
  • Glucose Metabolism Disorders / etiology*
  • Humans
  • Male
  • Middle Aged
  • Odds Ratio
  • Unemployment / psychology*
  • Unemployment / statistics & numerical data


  • Glucose