How Employers Can Identify and Manage Diabetes Risk Early

Diabetes is often the first visible sign of broader cardiometabolic health risk. By recognising it as an early warning signal, rather than a standalone condition, employers can take a more proactive approach to prevention, protecting workforce health, performance, and long-term costs.

Diabetes is global but often misunderstood and overlooked

 Diabetes is one of the fastest-growing global health challenges, yet it’s often misunderstood and addressed as an isolated condition. An estimated 589 million adults (20-79 years) worldwide are living with diabetes, and many remain undiagnosed [1].

Diabetes rarely develops in isolation. It is closely linked to a wider set of interconnected factors, including cardiovascular health, weight, blood sugar regulation and lifestyle behaviours. This interconnected risk, described by Cigna Healthcare as cardiodiabesity, reflects how these conditions are driven by shared underlying factors such as physical inactivity, nutrition, inflammation and stress, and how they evolve together over time.

As a result, diabetes is often identified only once clinical thresholds are reached, even though underlying risk may have been developing silently for years. Earlier stages, including prediabetes, are widespread but frequently missed without proactive screening and awareness.

Taken together, this suggests diabetes is not the starting point of risk, but one of the first visible signs of broader, underlying health decline.

Why early risk is often missed

Prediabetes, a high-risk state where blood sugar levels are elevated but not yet high enough for a Type 2 diabetes diagnosis, is often asymptomatic, meaning many people remain unaware that their risk is increasing.

In practice, the formal diagnosis can lag behind underlying biology—and even abnormal lab results—meaning risk may be present and measurable before it is formally recognised [2]. This creates a gap between when risk begins and when action is taken.

Early intervention is often limited by a combination of factors. Awareness remains low, with many individuals unaware of early-stage risk. Behavioural change can be difficult to sustain, even when risk is understood. And access to screening, support, and follow-up is not always consistent, making early action harder to implement.

As Dr Charu Thadani, Head of Clinical, MEA at Cigna Healthcare International Health, explains:

“Diabetes should prompt earlier action, not just later treatment. For employers, the real value lies in recognising risk sooner and ensuring screening leads to meaningful follow-up support that helps people make lasting health changes.”

Hidden workforce impact

Long before conditions such as diabetes are formally diagnosed, underlying health risk can begin to affect how people feel and perform at work.

Early-stage metabolic risk can reduce energy, concentration, and resilience, often without being linked to a specific condition. Employees may experience fatigue, reduced focus, or increased stress. The Cigna Healthcare International Health study on global well-being shows that 91% of employees with low vitality report experiencing stress, highlighting the close connection between health and performance [3].

For employers, this creates a measurable but often hidden impact. Reduced productivity, presenteeism and absenteeism can significantly affect organisational performance, with health-related productivity losses estimated to cost employers 2–3 times more than direct healthcare expenses [4]. In one employer-sponsored study, employees with Type 2 diabetes had 4.2 additional lost workdays compared to those without diabetes, alongside significantly higher productivity loss [5].

This means workforce performance may already be declining before risks are formally recognised — and before traditional interventions are triggered.

Employer opportunity: enabling early intervention

Addressing health risk earlier represents a more effective and higher-value approach, enabling organisations to reduce long-term risk before it escalates. When action is delayed until diagnosis, interventions are more complex, less effective, and more costly.

This creates a critical gap: the greatest opportunity to influence outcomes is often missed—not because risk is invisible, but because it is not acted on early enough.

Leading organisations are shifting toward more proactive, integrated approaches that help identify and address risk sooner. This includes prioritising early detection, improving understanding of key health indicators, and recognising individuals with risk factors such as raised blood pressure, excess weight or a family history of Type 2 diabetes, who may be at higher risk of progression.

However, identification alone is not enough, value comes from what happens next. Outcomes improve when screening is linked to coordinated care, including access to preventive services, structured lifestyle support, and ongoing monitoring. By connecting screening, support, and follow-up, employers can move beyond fragmented models and create more effective strategies that improve outcomes, while supporting more personalised care and stronger employee engagement.

Employer actions that support early intervention

To translate this approach into practice, employers can:

• Identify risk earlier through regular health screenings, including blood glucose and HbA1c testing — for example, by embedding biometric checks into annual health assessments or workplace wellness programmes
• Act on results quickly by linking screening to clear follow-up support, such as structured lifestyle coaching, nutrition programmes, or diabetes prevention programmes, rather than relying on awareness alone
• Reinforce progress through ongoing monitoring, using tools such as digital health platforms, follow-up testing, or wearable devices to help employees track and sustain behaviour change over time
• Improve access to preventative care, by ensuring benefits cover routine check-ups, onsite or virtual screenings, and early interventions — and by reducing practical barriers such as cost, time, and access to providers
• Take a more integrated approach to workforce health, connecting benefits, lifestyle support, and clinical care so that employees experience a single, joined-up pathway rather than separate programmes

From early warning to early action

Cigna Healthcare’s approach reflects this shift: focusing on earlier identification of risk and more coordinated pathways that connect screening, intervention, and ongoing support. For example, in some areas, Cigna Healthcare offers nurse-led clinical programmes for diabetes and cardiovascular conditions, providing one-to-one coaching, education and practical support to help individuals better manage their health and long-term risk.

By enabling earlier action and linking insight to meaningful follow-through, employers can improve outcomes for individuals while reducing long-term health and productivity risk.

Diabetes should not be seen as an endpoint, but as an early signal of broader health risk. Employers who act early are better positioned to support workforce health, sustain performance, and manage long-term costs.

Sources                                   

1. International Diabetes Federation (2025). Diabetes Facts and Figures show global impact for individuals, families and countries  https://idf.org/about%20diabetes/diabetes-facts-figures/ 
2. Nichols GA et al. (2019). Prevalence and predictors of delayed clinical diagnosis of Type 2 diabetes: a longitudinal cohort study. BMJ Open. https://pmc.ncbi.nlm.nih.gov/articles/PMC6481650/  
3. Cigna Healthcare International Health (2025). Global Well-being & Vitality Study. https://www.cignaglobal.com/global-well-being-and-vitality
4. World Health Organization (2023). Diabetes – Key facts. https://www.who.int/news-room/fact-sheets/detail/diabetes
5. American Diabetes Association (2022). Productivity Loss and Medical Costs Associated With Type 2 Diabetes Among Employees Aged 18-64 Years With Large Employer-Sponsored Insurance https://pubmed.ncbi.nlm.nih.gov/36048852/