Level of education is associated with coronary heart disease and chronic kidney disease in individuals with type 2 diabetes: a population-based study

Abstract

IntroductionTo study the relationship between education level and vascular complications in individuals with type 2 diabetes in Norway.Research design and methodsMultiregional population-based cross-sectional study of individuals with type 2 diabetes in primary care. Data were extracted from electronic medical records in the period 2012–2014. Information on education level was obtained from Statistics Norway. Using multivariable multilevel regression analyses on imputed data we analyzed the association between education level and vascular complications. We adjusted for age, sex, HbA1c, low-density lipoprotein cholesterol, systolic blood pressure, smoking and diabetes duration. Results are presented as ORs and 95% CIs.ResultsOf 8192 individuals with type 2 diabetes included, 34.0% had completed compulsory education, 49.0% upper secondary education and 16.9% higher education. The prevalence of vascular complications in the three education groups was: coronary heart disease 25.9%, 23.0% and 16.9%; stroke 9.6%, 7.4% and 6.6%; chronic kidney disease (estimated glomerular filtration rate <60 mL/min/1.73 m2) 23.9%, 16.8% and 12.6%; and retinopathy 13.9%, 11.5% and 11.7%, respectively. Higher education was associated with lower odds for coronary heart disease (OR 0.59; 95% CI 0.49 to 0.71) and chronic kidney disease (OR 0.75; 95% CI 0.60 to 0.93) compared with compulsory education when adjusting for age, sex, HbA1c, low-density lipoprotein cholesterol, systolic blood pressure, smoking and diabetes duration.ConclusionsIn a country with equal access to healthcare, high education level was associated with lower odds for coronary heart disease and chronic kidney disease in individuals with type 2 diabetes.

Factors Influencing the Control of Diabetes Measured via Glycated Hemoglobin Concentrations in Adults with Type 1 Diabetes

“…Level of education is another factor associated with poorer glycemic control and a higher risk of complications [3,[27][28][29]. The present study showed that having a tertiary education was associated with maintaining a normal glycated hemoglobin result below 7% in subjects with type 1 diabetes.…”

Development and validation of a risk score nomogram model to predict the risk of 5-year all-cause mortality in diabetic patients with hypertension: A study based on NHANES data

“…In the present study, two demographic variables, marital status and education level, were identified as parameters that can predict the risk of 5-year all-cause mortality, indicating that social support may play an important role in the clinical outcomes of both diabetes and hypertension. In a population-based study, Slåtsve et al [ 19 ]. demonstrated that higher education levels were associated with lower odds for coronary heart disease and chronic kidney disease in individuals with type 2 diabetes, and higher education was also found to affect their prognosis.…”

Prevalence and Hospitalizations of Cardiovascular Disease Complications in Adults with Diabetes: A Comprehensive USDDS Database Analysis

“…These findings suggest significant progress in CVD management and prevention strategies over the past two decades, possibly driven by advancements in medical care, improved access to healthcare services, and greater emphasis on preventive measures. Continued efforts to monitor and address cardiovascular risk factors among individuals with diabetes are essential to sustain these positive trends and further reduce the incidence of cardiovascular complications in this high-risk population [24][25][26].…”