Thirteen-year trends in the prevalence of diabetes according to socioeconomic condition and cardiovascular risk factors in a Swiss population

Abstract

IntroductionTo estimate the prevalence of and trends in diabetes according to sociodemographic indicators and cardiovascular risk factors in a Swiss population.Research design and methodsAnnual cross-sectional study of adults residing in the state of Geneva. We included 9886 participants (51% women; mean age (SD) of 48.9 (13.4) years). Diagnosed diabetes was self-reported; undiagnosed diabetes was defined as having fasting plasma glucose level of ≥7 mmol/L and no previous diagnosis; total diabetes as the sum of diagnosed and undiagnosed diabetes. To assess trends, we grouped survey years into three time periods: 2005–2010, 2011–2014, and 2015–2017. To assess inequalities, we constructed the relative index of inequality (RII) and the slope index of inequality (SII) for education, income, and health insurance subsidy (state program based on socioeconomic disadvantage).ResultsIn total, 683 diabetes cases were identified. In 2015–2017, total diabetes prevalence was 11.8% (8.6%–14.9%) among lowest income participants, and 4.7% (3.4%–5.9%) among highest income participants (p<0.01). Similar findings were observed for education. Among participants with full health insurance subsidy, diabetes prevalence was 19.4% (12.1%–26.8%), and 6.1% (5.3%–7.0%) among those without (p<0.01). High diabetes prevalence was observed among participants who were men, older, overweight or obese, hypertensive, and hypercholesterolemic. Among participants with diabetes, 74.0% (63.5%–84.4%) in the lowest income group were diagnosed, compared with 90.2% (81.9%–98.4%) in the highest income group (p=0.04). Over the 13-year period, widening relative and absolute inequalities in total diabetes prevalence were observed for education and income. The education-RII (95% CI) increased from 1.51 (95% CI 1.01 to 2.32) in 2005–2010 to 2.54 (95% CI 1.58 to 4.07) in 2015–2017 (p=0.01), and the education-SII (95% CI) from 0.04 (95% CI 0.01 to 0.08) to 0.08 (95% CI 0.04 to 0.10; p<0.01). The income-RII increased from 2.35 (95% CI 1.44 to 3.84) to 3.91 (95% CI 2.24 to 6.85; p<0.01), and the income-SII from 0.08 (95% CI 0.04 to 0.12) to 0.011 (95% CI 0.07 to 0.14; p=0.01). Inequalities by health insurance subsidy were large (RII 3.56 (95% CI 1.90 to 6.66) and SII 0.10 (95% CI 0.05 to 0.15)) but stable across the study period.ConclusionAmong adults living in Geneva, Switzerland, substantial differences were observed in diabetes prevalence across socioeconomic and cardiovascular risk groups over a 13-year period, and relative and absolute socioeconomic inequalities appeared to have increased.

Trends in glycemic, blood pressure, and lipid control in adults with diabetes in Switzerland: the CoLaus|PsyCoLaus Study

“…Analysis of data from a national telephone survey reported the prevalence of self-reported diabetes was 4.8% in 2007, up from 3.3% in 1997 2. In Lausanne, the prevalence of diabetes in adults aged 35–75 years was 6.3% in 2003–6, a third of whom were undiagnosed,3 comparable to the 6.5% prevalence reported in Geneva 4. This places Switzerland among the countries with the lowest diabetes prevalence in the world 5.…”

“… 2 In Lausanne, the prevalence of diabetes in adults aged 35–75 years was 6.3% in 2003–6, a third of whom were undiagnosed, 3 comparable to the 6.5% prevalence reported in Geneva. 4 This places Switzerland among the countries with the lowest diabetes prevalence in the world. 5 Nevertheless, Switzerland tops the global ranking in diabetes-related health expenditure, spending an estimated US$13 000 per adult with diabetes.…”

Trends in diabetes prevalence, awareness, treatment, and control in French-speaking Switzerland

“…In addition, disparities in diabetes prevalence among various socioeconomic and cardiovascular risk groups in the Geneva population have increased over 13 years. Compared with adults with a higher socioeconomic background,disadvantaged adults were less aware of their diabetic condition 8 .…”

Exploring the gender difference in type 2 diabetes incidence in a Swiss cohort using latent class analysis: an intersectional approach

“…10 Previous literature reported sex differences in type 2 diabetes epidemiology: worldwide and in high-income countries, men display an approximately 1-3-1.5-fold higher prevalence of type 2 diabetes than women. [11][12][13] In high-income Western countries in 2019, an agestandardised prevalence is of 7.3% in men and 5.3% in women, 14 although women are predominant among youth-onset diabetic patients. 3 Sex-disaggregated data on type 2 diabetes in Switzerland are scarce, but one study reported an age-adjusted prevalence of 7.8% in men and 5.7% in women.…”