Socioeconomic inequalities in cardiometabolic control in patients with type 2 diabetes
Abstract Background The aim of this study was to determine if the achievement of control targets in patients with type 2 diabetes was associated with personal socioeconomic factors and if these associations were sex-dependent. Methods This cross-sectional, population-based study was conducted in Spa...
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| Format: | Article |
| Language: | English |
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BMC
2018-03-01
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| Series: | BMC Public Health |
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| Online Access: | http://link.springer.com/article/10.1186/s12889-018-5269-0 |
| _version_ | 1811268422522109952 |
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| author | Berta Ibáñez Arkaitz Galbete María José Goñi Luis Forga Laura Arnedo Felipe Aizpuru Julián Librero Oscar Lecea Koldo Cambra |
| author_facet | Berta Ibáñez Arkaitz Galbete María José Goñi Luis Forga Laura Arnedo Felipe Aizpuru Julián Librero Oscar Lecea Koldo Cambra |
| author_sort | Berta Ibáñez |
| collection | DOAJ |
| description | Abstract Background The aim of this study was to determine if the achievement of control targets in patients with type 2 diabetes was associated with personal socioeconomic factors and if these associations were sex-dependent. Methods This cross-sectional, population-based study was conducted in Spain. Glycated haemoglobin (HbA1c) level and other clinical parameters were obtained from electronic primary care records (n = 32,638 cases). Socioeconomic status was determined using education level and yearly income. Among patients, having their HbA1c level checked during the previous year was considered as an indirect measure of the process of care, whereas tobacco use and clinical parameters such as HbA1c, low-density lipoprotein cholesterol (LDL-c) and blood pressure (BP) were considered intermediate control outcomes. General linear mixed effect models were used to assess associations. Results The achievement of metabolic and cardiovascular control targets in patients with type 2 diabetes was associated with educational level and income, and socioeconomic gradients differed by sex. The probability of having had an HbA1c test performed in the previous year was higher in patients with lower education levels. Patients in the lowest income and education level categories were less likely to have reached the recommended HbA1c level. Males in the lowest education level categories were less likely to be non-smokers or to have achieved the blood pressure targets. In contrast, patients within the low income categories had a higher probability of reaching the recommended LDL-c level. Conclusions Our results suggest the presence of socioeconomic inequalities in the achievement of cardiovascular and metabolic control that differed in direction and magnitude depending on the measured outcome and sex of the patient. These findings may help health professionals focus on high-risk individuals to decrease health inequalities. |
| first_indexed | 2024-04-12T21:22:27Z |
| format | Article |
| id | doaj.art-7f0ed84e42e4417ca02b3d02ac48f114 |
| institution | Directory Open Access Journal |
| issn | 1471-2458 |
| language | English |
| last_indexed | 2024-04-12T21:22:27Z |
| publishDate | 2018-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj.art-7f0ed84e42e4417ca02b3d02ac48f1142022-12-22T03:16:16ZengBMCBMC Public Health1471-24582018-03-011811910.1186/s12889-018-5269-0Socioeconomic inequalities in cardiometabolic control in patients with type 2 diabetesBerta Ibáñez0Arkaitz Galbete1María José Goñi2Luis Forga3Laura Arnedo4Felipe Aizpuru5Julián Librero6Oscar Lecea7Koldo Cambra8Navarrabiomed-CHN-UPNANavarrabiomed-CHN-UPNAIdiSNAIdiSNAInstituto de Estadística de NavarraRed de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC)Navarrabiomed-CHN-UPNAGerencia de Atención Primaria, Servicio Navarro de Salud-OsasunbideaRed de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC)Abstract Background The aim of this study was to determine if the achievement of control targets in patients with type 2 diabetes was associated with personal socioeconomic factors and if these associations were sex-dependent. Methods This cross-sectional, population-based study was conducted in Spain. Glycated haemoglobin (HbA1c) level and other clinical parameters were obtained from electronic primary care records (n = 32,638 cases). Socioeconomic status was determined using education level and yearly income. Among patients, having their HbA1c level checked during the previous year was considered as an indirect measure of the process of care, whereas tobacco use and clinical parameters such as HbA1c, low-density lipoprotein cholesterol (LDL-c) and blood pressure (BP) were considered intermediate control outcomes. General linear mixed effect models were used to assess associations. Results The achievement of metabolic and cardiovascular control targets in patients with type 2 diabetes was associated with educational level and income, and socioeconomic gradients differed by sex. The probability of having had an HbA1c test performed in the previous year was higher in patients with lower education levels. Patients in the lowest income and education level categories were less likely to have reached the recommended HbA1c level. Males in the lowest education level categories were less likely to be non-smokers or to have achieved the blood pressure targets. In contrast, patients within the low income categories had a higher probability of reaching the recommended LDL-c level. Conclusions Our results suggest the presence of socioeconomic inequalities in the achievement of cardiovascular and metabolic control that differed in direction and magnitude depending on the measured outcome and sex of the patient. These findings may help health professionals focus on high-risk individuals to decrease health inequalities.http://link.springer.com/article/10.1186/s12889-018-5269-0Socioeconomic statusSocioeconomic inequalitiesDiabetes mellitusDiabetes careCardiometabolic risk factorsCardiovascular control |
| spellingShingle | Berta Ibáñez Arkaitz Galbete María José Goñi Luis Forga Laura Arnedo Felipe Aizpuru Julián Librero Oscar Lecea Koldo Cambra Socioeconomic inequalities in cardiometabolic control in patients with type 2 diabetes BMC Public Health Socioeconomic status Socioeconomic inequalities Diabetes mellitus Diabetes care Cardiometabolic risk factors Cardiovascular control |
| title | Socioeconomic inequalities in cardiometabolic control in patients with type 2 diabetes |
| title_full | Socioeconomic inequalities in cardiometabolic control in patients with type 2 diabetes |
| title_fullStr | Socioeconomic inequalities in cardiometabolic control in patients with type 2 diabetes |
| title_full_unstemmed | Socioeconomic inequalities in cardiometabolic control in patients with type 2 diabetes |
| title_short | Socioeconomic inequalities in cardiometabolic control in patients with type 2 diabetes |
| title_sort | socioeconomic inequalities in cardiometabolic control in patients with type 2 diabetes |
| topic | Socioeconomic status Socioeconomic inequalities Diabetes mellitus Diabetes care Cardiometabolic risk factors Cardiovascular control |
| url | http://link.springer.com/article/10.1186/s12889-018-5269-0 |
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