Socio-economic inequalities in glycaemic control in recently diagnosed adults with type 1 and type 2 diabetes.
MetadataShow full item record
Seidel-Jacobs, E., Ptushkina, V., Strassburger, K., Icks, A., Kuss, O., Burkart, V., Szendroedi, J., et al. (2022). Socio-economic inequalities in glycaemic control in recently diagnosed adults with type 1 and type 2 diabetes.. Diabet Med https://doi.org/10.1111/dme.14833
Funder: The German Diabetes Study (GDS) was initiated and financed by the DDZ – German Diabetes Center, which is funded by the German Federal Ministry of Health (Berlin, Germany) and the Ministry of Innovation, Science, Research and Technology of the state North Rhine‐Westphalia (Düsseldorf, Germany) and from the German Federal Ministry of Education and Research (BMBF) to the German Center for Diabetes Research (DZD e.V.). The sponsors played no role in the planning, analysis, or preparation of this manuscript.
BACKGROUND AND AIMS: It is unclear whether socio-economic status (SES) is associated with glycaemic control in people with recently diagnosed diabetes. The aim was to investigate whether SES is related to haemoglobin A1c (HbA1c) during the first year after diagnosis in people with type 1 and type 2 diabetes and if metabolic, quality of care or mental factors may explain the association. METHODS: In the German Diabetes Study, people with type 1 (n = 274, median age 36 [25th; 75th percentile: 28; 48] years) and type 2 diabetes (n = 424, 54 [47; 60] years) underwent detailed metabolic characterisation within the first year after diagnosis. SES was documented using a standardised questionnaire. Associations between SES and HbA1c were assessed using multivariable linear regression and restricted cubic spline regression analyses. Additional covariables were patient characteristics, laboratory measurements, health behaviour, quality of care and depression variables. Models were separately fitted for diabetes type, SES and its dimensions (income, education, occupation). RESULTS: Higher SES score was associated with lower HbA1c (-0.7 mmol/mol per unit increase in SES, 95% CI: -1.1; -0.2 mmol/mol [-0.1%, 95% CI: -0.1; 0.0%]) in people with type 1 diabetes. Included covariates did not attenuate this association. In people with type 2 diabetes, effect estimates were close to zero indicating no relevant difference. CONCLUSION: Socio-economic inequalities in HbA1c already exist during the first year after diagnosis in people with type 1 diabetes. The absence of association between glycaemic control and SES in type 2 diabetes could be due to the lower complexity of diabetes therapy compared to type 1 diabetes.
RESEARCH ARTICLE, RESEARCH ARTICLES, blood glucose, diabetes, glycated haemoglobin A, social class
External DOI: https://doi.org/10.1111/dme.14833
This record's URL: https://www.repository.cam.ac.uk/handle/1810/335610