Socioeconomic position, type 2 diabetes and long-term risk of death.
<h4>Background</h4>Both socioeconomic position (SEP) and type 2 diabetes have previously been found to be associated with mortality; however, little is known about the association between SEP, type 2 diabetes and long-term mortality when comorbidity is taken into account.<h4>Method...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2015-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0124829 |
| _version_ | 1831586320161439744 |
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| author | Else-Marie Dalsgaard Mette V Skriver Annelli Sandbaek Mogens Vestergaard |
| author_facet | Else-Marie Dalsgaard Mette V Skriver Annelli Sandbaek Mogens Vestergaard |
| author_sort | Else-Marie Dalsgaard |
| collection | DOAJ |
| description | <h4>Background</h4>Both socioeconomic position (SEP) and type 2 diabetes have previously been found to be associated with mortality; however, little is known about the association between SEP, type 2 diabetes and long-term mortality when comorbidity is taken into account.<h4>Methods</h4>We conducted a population-based cohort study of all Danish citizens aged 40-69 years with no history of diabetes during 2001-2006 (N=2,330,206). The cohort was identified using nationwide registers, and it was followed for up to 11 years (mean follow-up was 9.5 years (SD: 2.6)). We estimated the age-standardised mortality rate (MR) and performed Poisson regression to estimate the mortality-rate-ratio (MRR) by educational level, income and cohabiting status among people with and without type 2 diabetes.<h4>Results</h4>We followed 2,330,206 people for 22,971,026 person-years at risk and identified 139,681 individuals with type 2 diabetes. In total, 195,661 people died during the study period; 19,959 of these had type 2 diabetes. The age-standardised MR increased with decreasing SEP both for people with and without diabetes. Type 2 diabetes and SEP both had a strong impact on the overall mortality; the combined effect of type 2 diabetes and SEP on mortality was additive rather than multiplicative. Compared to women without diabetes and in the highest income quintile, the MRR's were 2.8 (95%CI 2.6, 3.0) higher for women with type 2 diabetes in the lowest income quintile, while diabetes alone increased the risk of mortality 2.0 (95%CI 1.9, 2.2) times and being in the lowest income quintile without diabetes 1.8 (95%CI 1.7,1.9) times after adjusting for comorbidity. For men, the MRR's were 2.7 (95%CI 2.5,2.9), 1.9 (95%CI 1.8,2.0) and 1.8 (95%CI 1.8,1.9), respectively.<h4>Conclusion</h4>Both Type 2 diabetes and SEP were associated with the overall mortality. The relation between type 2 diabetes, SEP, and all-cause mortality was only partly explained by comorbidity. |
| first_indexed | 2024-12-17T21:34:11Z |
| format | Article |
| id | doaj.art-442cd74635884cb29c998feb32b5f93f |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-17T21:34:11Z |
| publishDate | 2015-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-442cd74635884cb29c998feb32b5f93f2022-12-21T21:31:47ZengPublic Library of Science (PLoS)PLoS ONE1932-62032015-01-01105e012482910.1371/journal.pone.0124829Socioeconomic position, type 2 diabetes and long-term risk of death.Else-Marie DalsgaardMette V SkriverAnnelli SandbaekMogens Vestergaard<h4>Background</h4>Both socioeconomic position (SEP) and type 2 diabetes have previously been found to be associated with mortality; however, little is known about the association between SEP, type 2 diabetes and long-term mortality when comorbidity is taken into account.<h4>Methods</h4>We conducted a population-based cohort study of all Danish citizens aged 40-69 years with no history of diabetes during 2001-2006 (N=2,330,206). The cohort was identified using nationwide registers, and it was followed for up to 11 years (mean follow-up was 9.5 years (SD: 2.6)). We estimated the age-standardised mortality rate (MR) and performed Poisson regression to estimate the mortality-rate-ratio (MRR) by educational level, income and cohabiting status among people with and without type 2 diabetes.<h4>Results</h4>We followed 2,330,206 people for 22,971,026 person-years at risk and identified 139,681 individuals with type 2 diabetes. In total, 195,661 people died during the study period; 19,959 of these had type 2 diabetes. The age-standardised MR increased with decreasing SEP both for people with and without diabetes. Type 2 diabetes and SEP both had a strong impact on the overall mortality; the combined effect of type 2 diabetes and SEP on mortality was additive rather than multiplicative. Compared to women without diabetes and in the highest income quintile, the MRR's were 2.8 (95%CI 2.6, 3.0) higher for women with type 2 diabetes in the lowest income quintile, while diabetes alone increased the risk of mortality 2.0 (95%CI 1.9, 2.2) times and being in the lowest income quintile without diabetes 1.8 (95%CI 1.7,1.9) times after adjusting for comorbidity. For men, the MRR's were 2.7 (95%CI 2.5,2.9), 1.9 (95%CI 1.8,2.0) and 1.8 (95%CI 1.8,1.9), respectively.<h4>Conclusion</h4>Both Type 2 diabetes and SEP were associated with the overall mortality. The relation between type 2 diabetes, SEP, and all-cause mortality was only partly explained by comorbidity.https://doi.org/10.1371/journal.pone.0124829 |
| spellingShingle | Else-Marie Dalsgaard Mette V Skriver Annelli Sandbaek Mogens Vestergaard Socioeconomic position, type 2 diabetes and long-term risk of death. PLoS ONE |
| title | Socioeconomic position, type 2 diabetes and long-term risk of death. |
| title_full | Socioeconomic position, type 2 diabetes and long-term risk of death. |
| title_fullStr | Socioeconomic position, type 2 diabetes and long-term risk of death. |
| title_full_unstemmed | Socioeconomic position, type 2 diabetes and long-term risk of death. |
| title_short | Socioeconomic position, type 2 diabetes and long-term risk of death. |
| title_sort | socioeconomic position type 2 diabetes and long term risk of death |
| url | https://doi.org/10.1371/journal.pone.0124829 |
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