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Estimate the impact of diabetes and neuropathic pain on the US workforce.Data on lost productive time (LPT) was collected by telephone interview in a random sample of the US population (N = 36,634). Of 19,075 occupation-eligible working adults included in the analysis, 1003 reported a physician diagnosis of diabetes; 38% of these reported numbness or tingling in feet or hands due to diabetes (symptom group). We compared diabetes respondents with and without symptoms to other respondents for LPT and related cost.Health-related LPT was 18% higher in the symptom (P < 0.05) and 5% higher in the non-symptom (P < 0.05) groups versus for those without diabetes. The symptom group lost 1.4 hours of work per week more than the non-symptom group (P < 0.05).Workers who have diabetes with neuropathic symptoms lose the equivalent of $3.65 billion/yr in health-related LPT.