Do people with type 2 diabetes and their carers lose income? (T2ARDIS-4).

T(2)ARDIS is a study of the full costs of care for a sample of people with type 2 diabetes in the UK. This paper reports on individual earnings lost by patients (n=653) and carers (n=253) aged <65 years, based on 1998 values. Mean annual lost earnings are calculated on three different bases. Across the total survey population aged <65 years, mean lost earnings are estimated at pound 869 (S.D. pound 4109) per patient and pound 1300 (S.D. pound 4093) per carer. However, for the sub-set of respondents who actually lose earnings, the mean levels are pound 13841 (S.D. pound 9551) and pound 10960 (S.D. pound 6002), respectively. Patients and carers who lose earnings incur higher personal care-related expenditure than those who do not lose earnings (although for the patients this is not statistically significant). Patients who lose earnings also report poorer health-related quality of life and carers who lose earnings report higher levels of strain. Only one third of carers report receiving state benefits, and for both carers and patients the shortfall between reported benefits received and lost earnings is substantial. A strong association was found between patients' loss of earnings and the presence of diabetic complications (P<0.001), especially micro-vascular complications. Policy priorities should, therefore, include facilitating comprehensive access to state benefits (especially for carers) and a clear focus on reducing the incidence of diabetic complications.