Social inequalities and outcomes in type 2 diabetes in the German region of Augsburg. A cross-sectional survey.

Reisig, Veronika; Reitmeir, Peter; Döring, Angela; Rathmann, Wolfgang; Mielck, Andreas

doi:10.1007/s00038-007-5077-2

Cited by 45 publications

(57 citation statements)

References 29 publications

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“…This relatively novel area of research represents an extension of previous studies of the association between sociodemographic factors and type 2 diabetes. A German study found that HbA 1c levels are strongly associated with socioeconomic position, favouring the better off [23]. Similar results have been found in other countries [24][25][26].…”

Section: Introductionsupporting

confidence: 70%

Country of birth, socioeconomic factors, and risk factor control in patients with type 2 diabetes: a Swedish study from 25 primary health‐care centres

Sundquist

Chaikiat

León

et al. 2011

Diabetes Metabolism Res

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Section: Introductionsupporting

confidence: 70%

Country of birth, socioeconomic factors, and risk factor control in patients with type 2 diabetes: a Swedish study from 25 primary health‐care centres

Sundquist

Chaikiat

León

et al. 2011

Diabetes Metabolism Res

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“…These two indicators were used side by side [20,25,27] or combined with the indicator ‘occupational status’ in order to build an index of SES [21,23,32,36]. The association between regional deprivation and quality of health care was evaluated in 11 studies.…”

Section: Resultsmentioning

confidence: 99%

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

Grintsova

Maier

Mielck

2014

Int J Equity Health

Self Cite

148

130

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IntroductionQuality of care could be influenced by individual socio-economic status (SES) and by residential area deprivation. The objective is to synthesize the current evidence regarding inequalities in health care for patients with Type 2 diabetes mellitus (Type 2 DM).MethodsThe systematic review focuses on inequalities concerning process (e.g. measurement of HbA1c, i.e. glycolised haemoglobin) and intermediate outcome indicators (e.g. HbA1c level) of Type 2 diabetes care. In total, of n = 886 publications screened, n = 21 met the inclusion criteria.ResultsA wide variety of definitions for ‘good quality diabetes care’, regional deprivation and individual SES was observed. Despite differences in research approaches, there is a trend towards worse health care for patients with low SES, concerning both process of care and intermediate outcome indicators. Patients living in deprived areas less often achieve glycaemic control targets, tend to have higher blood pressure (BP) and worse lipid profile control.ConclusionThe available evidence clearly points to the fact that socio-economic inequalities in diabetes care do exist. Low individual SES and residential area deprivation are often associated with worse process indicators and worse intermediate outcomes, resulting in higher risks of microvascular and macrovascular complications. These inequalities exist across different health care systems. Recommendations for further research are provided.

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“…These factors are less access to and use of healthcare services and poorer quality of the care process, as well as lower levels of diabetes education and control of variables related to diabetes (e.g. glycaemia, weight, cholesterol) for patients that occupy a disadvantaged SEP [2,8,21].…”

Section: Discussionmentioning

confidence: 99%

“…In this respect, cigarette smoking is associated with a low glomerular filtration rate [16] and dietary patterns may influence the risk of type 2 diabetes [17], and these health behaviours, as well as obesity, are related with SEP [19,20]. Other factors related to inequalities in diabetes mortality are socioeconomic differences in terms of access to and use and quality of healthcare services for patients with diabetes, including diabetes education and diabetes control [2,8,21].…”

Section: Introductionmentioning

confidence: 99%

Socioeconomic inequalities in diabetes mellitus across Europe at the beginning of the 21st century

et al. 2008

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Aims/hypothesis The aim of this study was to determine and quantify socioeconomic position (SEP) inequalities in diabetes mellitus in different areas of Europe, at the turn of the century, for men and women. Methods We analysed data from ten representative national health surveys and 13 mortality registers. For national health surveys the dependent variable was the presence of diabetes by self-report and for mortality registers it was death from diabetes. Educational level (SEP), age and sex were independent variables, and age-adjusted prevalence ratios (PRs) and risk ratios (RRs) were calculated. ResultsIn the overall study population, low SEP was related to a higher prevalence of diabetes, for example men who attained a level of education equivalent to lower secondary school or less had a PR of 1.6 (95% CI 1.4-1.9) compared with those who attained tertiary level education, whereas the corresponding value in women was 2.2 (95% CI 1.9-2.7). Moreover, in all countries, having a disadvantaged SEP is related to a higher rate of mortality from diabetes and a linear relationship is observed. Eastern European countries have higher relative inequalities in mortality by SEP. According to our data, the RR of dying from diabetes for women with low a SEP Diabetologia (2008) 51:1971-1979 DOI 10.1007/s00125-008-1146 3.4 (95% CI 2.6-4.6), while in men it is 2.0 (95% CI 1.7-2.4). Conclusions/interpretation In Europe, educational attainment and diabetes are inversely related, in terms of both morbidity and mortality rates. This underlines the importance of targeting interventions towards low SEP groups. Access and use of healthcare services by people with diabetes also need to be improved.

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Social inequalities and outcomes in type 2 diabetes in the German region of Augsburg. A cross-sectional survey.

Abstract: Social inequalities in glycaemic control do exist. This finding may indicate a level of diabetes care that is inappropriate to the need of socially disadvantaged groups.

Cited by 45 publications

References 29 publications

Country of birth, socioeconomic factors, and risk factor control in patients with type 2 diabetes: a Swedish study from 25 primary health‐care centres

Country of birth, socioeconomic factors, and risk factor control in patients with type 2 diabetes: a Swedish study from 25 primary health‐care centres

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

Socioeconomic inequalities in diabetes mellitus across Europe at the beginning of the 21st century

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