Diabetes mellitus: up-to-date on antidiabetic drugs and hypoglycemic risk for the occupational physician

Main Article Content

Emanuela Orsi
Veronica Resi




Diabetes Mellitus (DM) is a complex, chronic illness requiring continuous medical care with multifactorial risk-reduction strategies beyond glycemic control. Diabetes and hyperglycemia cause chronic complications: cardiovascular disease, blindness, kidney failure and lower-limb amputation, that can lead to the exclusion of some work tasks. Diabetes drugs, as insulin or sulphonylureas, can cause hypoglycemia and the worker may be at risk of accidents. In recent years, numerous innovative drugs have become available and it is very important that the occupational physician knows their mechanism of action and their side effects since they could influence the worker’s job. Finally, the occupational physician could play a role in the prevention of type 2 diabetes: this is why it is important to know the disease, how to diagnose it and how to change the lifestyle in workers at risk.


Download data is not yet available.
Abstract 23 | PDF Downloads 18


Cho NH, IDF Diabetes Atlas: Global estimates of diabetes prevalence for 2017 and projections for 2045.Diabetes Res Clin Pract. 2018 Apr;138:271-281
Fan W, Epidemiology in diabetes mellitus and cardiovascular disease. Cardiovascular Endocrinology 2017, 6:8–16.
American Diabetes Association (ADA). Standards of Medical Care in Diabetes. Diabetes Care, 42 (Suppl 1) 1-202, 2019
Schofield D, Cunich MM, Shrestha RN, et al. The economic impact of diabetes through lost labour force participation on individuals and government: evidence from a microsimulation model. BMC Public Health 2014;14:220
Tunceli K, Bradley CJ, Nerenz D, et al. The impact of diabetes on employment and work productivity. Diabetes Care 2005;28:2662-7.
Taylor R, Diabetes. 2012 Apr; 61(4): 778–779. Insulin Resistance and Type 2 Diabetes
Bazotte RB, Silva LG, and Schiavon FPM, Insulin resistance in the liver: Deficiency or excess of insulin? Cell Cycle. 2014 Aug 15; 13(16): 2494–2500
Associazione Medici Diabetologi (AMD) – Società Italiana di Diabetologia (SID) Standard Italiani per la Cura del Diabete Mellito 2018
Duckworth W, Abraira C, Glucose Control and Vascular Complications in Veterans with Type 2 Diabetes. N Engl J Med 2009; 360:129-139
Neal B, Perkovic V, Canagliflozin and Cardiovascular and Renal Events in Type 2 Diabetes.N Engl J Med. 2017 Aug 17;377(7):644-657.
Jardine MJ, Mahaffey KWThe Canagliflozin and Renal Endpoints in Diabetes with Established Nephropathy Clinical Evaluation (CREDENCE) Study Rationale, Design, and Baseline Characteristics Am J Nephrol. 2017 Dec 13;46(6):462-472
Gerstein HC, Colhoun HM Dulaglutide and cardiovascular outcomes in type 2 diabetes (REWIND): a double-blind, randomised placebo-controlled trial. Lancet. 2019 Jul 13;394(10193):121-130
Bernard Zinman, M.D., Christoph Wanner  Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes N Engl J Med 2015; 373:2117-2128
Stephen D. Wiviott, M.D., Itamar Raz, Dapagliflozin and Cardiovascular Outcomes in Type 2 Diabetes N Engl J Med 2019; 380:347-357
Davies M, Management of hyperglycaemia in type 2 diabetes, 2018. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetologia 2018, https://doi.org/10.1007/s00125-018-4729-5
Diabetes and Employment American Diabetes Association Diabetes Care. 2009 Jan; 32(Suppl 1): S80–S84.
Iavicoli I, Diabetes and work: The need of a close collaboration between diabetologist and occupational physician Nutrition, Metabolism and Cardiovascular Disease Volume 29, Issue 3, March 2019, Pages 220-227