Inequalities in glycaemic control in patients with Type 2 diabetes in primary care

Abstract

Several patient and practice factors are related to glycaemic control. Poorer glycaemic control was associated with practice level deprivation and nurses undertaking annual reviews alone. Further research is required to explore outcomes of annual reviews undertaken by nurses alone. Greater resources may be needed by primary care teams working in deprived areas to address inequalities in diabetic control.

Association of age, sex and deprivation with quality indicators for diabetes: population-based cross sectional survey in primary care

“…Our findings confirm previous research which has shown that ageing is associated with improved glycaemic control, [11][12][13] but an increased likelihood of hypertension. 14,15 Our findings are also consistent with the recent National Diabetes Audit in England, 16 which suggested that older patients may be more likely to achieve cholesterol treatment targets.…”

“…This finding contrasts with recent evidence of persistent age inequalities in the secondary prevention of coronary heart disease. 6,7 Our findings confirm recent research which suggests that glycaemic control may be similar in women and men, 4,11 but that women with diabetes are more likely to have poorly controlled cholesterol. 4 Intermediate treatment outcomes were not significantly different amongst participants living in deprived areas compared with those living in 580…”

Inequalities in health care among patients with type 2 diabetes by individual socio-economic status (SES) and regional deprivation: a systematic literature review

“…In five of them (all from the UK), this was the primary objective of the study, using different tools to assess regional deprivation, i.e. the Townsend score [22,30,33], the Carstairs deprivation score [29] and the Index of Multiple Deprivation (IMD) [24,28,35]. In the other three studies, regional deprivation was used as a proxy for individual SES.…”

“…In nine of them, higher regional deprivation is associated with higher HbA1c values, and patients living there achieve the glycaemic control targets less often; these differences are statistically significant [22,30,33,34,38] or show a similar trend [24,26,28,35]. No difference between deprivation groups was found in just one study [29].…”

“…Owing to potential selection bias, it could be difficult, though, to apply the results to the general population. A third group of studies is based on surveys [22,23,32,36]. They might be more representative of the whole population, but they often lack information regarding process indicators.…”