Introduction The Italian health system guarantees care to all citizens. Previous research reported socio-demographic differences in access to evidence-based therapies, whereas studies evaluating differences in healthcare related outcomes are scarce.

Objectives Analysing socio-demographic and geographical differences in healthcare related outcomes in patients with diabetes mellitus (DM).

Methods Among all residents registered with the regional healthcare service in 2008, adult patients with DM were identified through a validated predictive model from the regional administrative health information systems (hospital discharges, drug claims, exemptions for DM). Healthcare related outcomes were hospitalisation for uncontrolled DM, short-term complications, long-term complications, and amputation of lower limb (excluding traumatic amputations). Age standardised rates were calculated by gender, geographic area and socio-economic position (SEP) of residence (only for the city of Rome, 5 levels), and RRs were calculated.

Results In 2008, 2569 cases of complications were registered among the 303.016 DM patients, with higher prevalence among males. Incidence rates varied between 0.8/1000 for short-term and 4.2/1000 for long-term complications. Geographic variations were not statistically significant. Incidence of admissions for uncontrolled DM and short-term complications increased with decreasing socio-economic position in both genders. A significant risk increase was observed among males with lowest respect to highest SEP for amputations (RR=5.88, 95% CI 1.69 to 20.51) and for short-term complications (RR=12.58, 95% CI 2.83 to 55.91).

Conclusions In the Lazio region, complications of DM are more frequent among males. In Rome, the risk of complications is higher in DM patients belonging to lower SEP.