Socio‐economic status, obesity and prevalence of Type 1 and Type 2 diabetes mellitus

Evans, Josie; Newton, R. W.; Ruta, Danny; MacDonald, Thomas M.; Morris, Andrew D.

doi:10.1046/j.1464-5491.2000.00309.x

Cited by 292 publications

(195 citation statements)

References 6 publications

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“…This result contrasts sharply with the significant effect of diabetes on mortality in a population of older diabetic people that included newly diagnosed individuals and those with a longer duration of disease (5). Studies that have found small differences in mortality, even in men diagnosed at a later age, have not adjusted for the confounding effect of deprivation (possibly independently associated with diabetes prevalence [13] and mortality).…”

Section: Research Design and Methods -The Darts/memo (Diabetes Audit mentioning

confidence: 81%

Diagnosis of Type 2 Diabetes at an Older Age

et al. 2004

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OBJECTIVE -To compare the mortality of people who were diagnosed with type 2 diabetes over 65 years of age with that of nondiabetic individuals. RESEARCH DESIGN AND METHODS-Using a population-based diabetes information system for an observational cohort study in Tayside, Scotland, people who were diagnosed with type 2 diabetes over the age of 65 years between 1993 and 2002 were identified. Nondiabetic comparators, matched for age and sex, were identified from the nondiabetic population. The two cohorts were followed up for mortality and cardiovascular mortality according to death certification records.RESULTS -There were 3,594 people with type 2 diabetes (48% male) and 7,188 matched comparators identified in the study. Over a mean follow-up period of 4.6 Ϯ 2.9 years for 3,594 people with type 2 diabetes and 7,188 comparators, 909 (25.3%) patients in the diabetic cohort and 1,651 (23.0%) in the nondiabetic cohort died. The adjusted relative risk for mortality in the diabetic cohort compared with the nondiabetic cohort was 1.06 (95% CI 0.94 -1.19) for men and 1.29 (1.15-1.45) for women. Cardiovascular deaths accounted for 49.4% of the deaths in people with and 45.2% in those without diabetes (adjusted relative risk 1.01 [0.93-1.10]).CONCLUSIONS -Men diagnosed with type 2 diabetes over the age of 65 years have no excess mortality compared with their nondiabetic counterparts, a finding that was not replicated for women. Diabetes Care 27:2797-2799, 2004D iabetes is known to reduce life expectancy in older people (1). However, older people with diabetes are a heterogeneous group, including newly diagnosed people and those whose diagnosis may have occurred up to 20 years previously (2-4). Some research suggests that the effect on mortality of a diagnosis of diabetes becomes progressively less as age at diagnosis increases (5). A group of older people whose diabetes was detected by screening had an increased risk of mortality (6), and even patients who were diagnosed with diabetes over the age of 80 years had a reduced life expectancy of ϳ1 year (7). However, two European studies found no difference in mortality between men diagnosed with diabetes over the age of 75 years and nondiabetic men (8,9). We compared all-cause and cardiovascular mortality in cohorts of people diagnosed with type 2 diabetes at an older age with that in nondiabetic individuals. RESEARCH DESIGN AND METHODS -The DARTS/MEMO (Diabetes Audit and Research in TaysideScotland/Medicines Monitoring Unit) Collaboration (9) works on the record linkage of health care data to facilitate epidemiological and health services research in the population of Tayside, Scotland (estimated population of 389,800 in 1998). Record linkage is enabled by the widespread use of a unique health care identifier (community health index number) that is allocated to people when they register with a general practitioner in Scotland. This study was conducted in a defined population of general practitioner-registered people who were known to be residents of Tayside during the entire ...

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Section: Research Design and Methods -The Darts/memo (Diabetes Audit mentioning

confidence: 81%

Diagnosis of Type 2 Diabetes at an Older Age

et al. 2004

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“…Further, regional socioeconomic conditions were assessed from a broad spectrum of socioeconomic indicators taken from annually updated official statistics for the total population or from a standardised, continuous household sample survey (the German Microcensus). Thus, in contrast to many other ecological studies based on census data covering only a short period [9,10,12,17,19,21,26,27], our socioeconomic data covered a reasonable time span.…”

Section: Discussionmentioning

confidence: 96%

“…In Germany, as in other European countries, the growing social inequality among children is a serious problem [6]. Epidemiological studies on the association between social status and type 1 diabetes in children have reported conflicting results, finding positive [7][8][9][10][11][12][13][14][15][16][17], inverse [18][19][20][21][22][23][24][25] or no associations [26][27][28]. Likewise, the results of studies on the relation with population density and with urban versus rural areas are contradictory [10,13,14,17,19,29,30].…”

Section: Introductionmentioning

confidence: 99%

Socioeconomic conditions and type 1 diabetes in childhood in North Rhine–Westphalia, Germany

et al. 2007

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Aims/hypothesis The aim of the study was to investigate the relationships between childhood type 1 diabetes and socioeconomic conditions, which might provide clues to the aetiology of the disease. Materials and methodsIn an ecological study, we investigated the relationships between socioeconomic conditions and the incidence of type 1 diabetes incidence among children aged 0-14 years in North Rhine-Westphalia (NRW), Germany, between 1996 and 2000 at the level of the 33 districts. Incidence data were obtained from the population-based NRW diabetes register and regional socioeconomic data from official statistics. Associations were assessed by Poisson regression models and Bayesian conditionally autoregressive regression models (CAR). Results In simple Poisson regression, population density, proportion of non-German nationals in the population, measures of income, education and professional training, and deprivation scores were significantly associated with diabetes risk (p<0.01). An increase of about one interquartile range (IQR) in population density, proportion of non-German nationals or household income was associated with a 9-12% decrease in diabetes incidence. A rise of about one IQR in income ratio, measures of education and professional training, or in deprivation score (high values correspond to high deprivation) was associated with an 8-12% incidence increase. There was a significantly 'linear' increasing incidence trend across five deprivation classes (relative risk: 1.06; 95% CI: 1.03-1.09). All associations were confirmed when overdispersion and spatial autocorrelation were accounted for in Poisson and CAR models. Conclusions/interpretationsThe results raise the possibility that the risk for type 1 diabetes is higher for children living in socially deprived and less densely populated areas. Subsequent investigations are necessary to verify the observed ecological relations at the individual level and to identify the causal factors behind the socioeconomic indicators. Diabetologia (2007) 50:720-728

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“…Of the lifestyle factors, obesity is a public health concern globally and is shown to be highly prevalent in socioeconomically deprived areas of the population in the United Kingdom (30). Obesity is also known to cluster with several risk factors and markers suggested to be causally related with CKD and an independent predictor of CKD in the population (31).…”

Section: Discussionmentioning

confidence: 99%

Socioeconomic Status and Chronic Kidney Disease at Presentation to a Renal Service in the United Kingdom

Bello

Peters

Rigby

et al. 2008

Clinical Journal of the American Society of Nephrology

109

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Background and objectives: Low socioeconomic status (SES) is associated with both development and progression of chronic kidney disease (CKD). The impact of SES on severity of CKD at presentation to a renal service is less well known. This study investigated the relationship between SES and severity of CKD in a retrospective, cross-sectional analysis involving 1657 patients at the Sheffield Kidney Institute (Sheffield, UK).Design, setting, participants, & measurements: SES was assigned to each patient according to electoral ward of residence by postcode and ranked according to the corresponding British Index of Multiple Deprivation score, which comprises five deprivation quintiles (Q1, least deprived; Q5, most deprived). National Kidney Foundation Kidney Disease Outcomes Quality Initiative classification of CKD was used for stratification and analysis. Binary logistic regression analysis was applied for the association of variables/risk factors with CKD (lower GFR) at presentation.Results: The age-adjusted prevalence of diagnosed CKD at presentation by area of residence, across the five deprivation quintiles, per million population was Q1 ‫؍‬ 1495, Q2 ‫؍‬ 3530, Q3 ‫؍‬ 3398, Q4 ‫؍‬ 3989, and Q5 ‫؍‬ 19,599. Logistic regression models showed that living in the lowest SES quintile area (Q5) as compared with the highest SES (Q1) was associated with a greater risk for presenting with a lower estimated GFR, after adjustment for sociodemographic, lifestyle, and clinical variables.Conclusions: Low SES is related to severity of CKD at presentation. Further studies are needed to examine this issue across the various SES categories in the United Kingdom.

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Socio‐economic status, obesity and prevalence of Type 1 and Type 2 diabetes mellitus

Abstract: The study confirms the relationship between deprivation and the prevalence of Type 2 diabetes. There are more obese, diabetic patients in deprived areas. They require more targeted resources and more primary prevention.

Cited by 292 publications

References 6 publications

Diagnosis of Type 2 Diabetes at an Older Age

Diagnosis of Type 2 Diabetes at an Older Age

Socioeconomic conditions and type 1 diabetes in childhood in North Rhine–Westphalia, Germany

Socioeconomic Status and Chronic Kidney Disease at Presentation to a Renal Service in the United Kingdom

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