Article Text

other Versions

PDF
Socioeconomic status and diabetes-related hospital admissions: a cross-sectional study of people with diagnosed diabetes
  1. Sarah H Wild1,
  2. John A McKnight2,
  3. Alex McConnachie3,
  4. Robert S Lindsay4 on behalf of the Glasgow and Lothian Diabetes Register Data Group
  1. 1Public Health Sciences, University of Edinburgh, Scotland, UK
  2. 2Metabolic Unit, Western General Hospital, Edinburgh, Scotland, UK
  3. 3Robertson Centre for Biostatistics, University of Glasgow, Scotland, UK
  4. 4BHF Cardiovascular Research Centre, University of Glasgow, Scotland, UK
  1. Correspondence to Dr Sarah Wild, Public Health Sciences, University of Edinburgh, Teviot Place, Edinburgh EH8 9AG, Scotland, UK; Sarah.wild{at}ed.ac.uk

Abstract

Background Low socioeconomic status (SES) is associated with adverse cardiovascular risk factor patterns and poorer outcomes for people with diabetes

Methods A cross-sectional study was performed using data for 35 925 people with diagnosed diabetes in Scotland and an area-based measure of SES using linked hospital and population-based diabetes register records. Comparisons by quintile of SES were made before (with p values presented for trend across quintiles given below) and after adjusting for other factors using multivariable logistic regression.

Results People in the most deprived quintile were more likely than people in the most affluent quintile to have hospital records for diabetic kidney disease (2.4% vs 2.0%, p=0.049), diabetic ketoacidosis (3.5% vs 3.0%, p=0.11), hypoglycaemia (1.8% vs 1.4%, p=0.008), ischaemic heart disease (22% vs 17%, p<0.0001), stroke (6.8% vs 5.1%, p<0.0001) and peripheral arterial disease (4.1% vs 2.1%, p<0.0001). An independent effect of SES persisted for cardiovascular disease outcomes after adjusting for age and sex. There were minimal differences in disease management measures by SES.

Conclusion Managing current risk factors equitably is unlikely to remove socioeconomic inequalities in diabetes-related outcomes. Measures of SES may be valuable in risk scores and in making valid comparisons of the quality of diabetes care.

  • Diabetes complications
  • population register
  • social inequalities
  • socioeconomic status

Statistics from Altmetric.com

Footnotes

  • Funding This study was funded by Diabetes UK, NHS Lothian Research and Development Fund.

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the Glasgow and Lothian local research ethics committees.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.