Type 2 diabetes mellitus among beneficiaries of the french national health insurance for self-employed workers (AMPI): comparison of the management of craftsmen or tradesmen with professionals patients.
BACKGROUND
Although the management of diabetes mellitus varies according to non medical factors, the influence of socioprofessional category has been not fully studied. This study compared the management of type 2 diabetes mellitus in craftsmen or tradesmen with professionals categories.


METHODS
All claims to the French National Sickness Insurance Fund for self-employed workers (AMPI) from its mainland France beneficiaries in 1998 were retrospectively analysed. Patients were beneficiaries, insured or dependants of craftsmen or tradesmen, or professionals receiving oral hypoglycemic drugs during a 3-month inclusion period. Patients were compared on the proportion of care received in private practice over the preceding 12 months using adjusted odds ratio (OR).


RESULTS
Compared to patients in professionals (n=1,456), patients in craftsmen or tradesmen (n=35,703) were statistically more likely to see a general practitioner (OR 3.867, 95% CI=3.048; 4.907), to have blood glucose test (OR 1.530, 95% CI=1.332; 1.757) and serum creatinine assay (OR 1.207, 95% CI=1.052; 1.270). They were statistically less likely to consult or have a specialist procedure (ophthalmologist, OR 0.792, 95% CI=0.698; 0.900; cardiologist, OR 0.749, 95% CI=0.658; 0.852; dentist, OR 0.679, 95% CI=0.596; 0.773; endocrinologist, OR 0.522, 95% CI=0.424; 0.642), microalbuminuria test (OR 0.749, 95% CI=0.622; 0.902) and serum creatinine assay or microalbuminuria test (OR 0.746, 95% CI=0.611; 0.912). The two groups did not differ on HbA1c, blood lipid tests and electrocardiogram.


CONCLUSIONS
The management of type 2 diabetes mellitus differed between craftsmen or tradesmen and professionals patients. These results should be confirmed.
Auleley
G-R
GR
Service Médical National, Caisse Nationale d'Assurance Maladie (CANAM), Régime AMPI, Centre Paris-Pleyel, Saint-Denis, France.
Dematons
M N
MN
Berchery
P
P
Raynal-Minville
F
F
Suarez
F
F
Heuls-Bernin
B
B
Blum-Boisgard
C
C
D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D016208:Databases, Factual; D003924:Diabetes Mellitus, Type 2 / Q000191:economics / Q000453:epidemiology* / Q000628:therapy; D003928:Diabetic Nephropathies / Q000453:epidemiology / Q000628:therapy; D004651:Employment / Q000145:classification* / Q000706:statistics & numerical data; D005194:Family Practice; D005260:Female; D005602:France / Q000453:epidemiology; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D015994:Incidence; D008297:Male; D008511:Medicine / Q000145:classification; D009313:National Health Programs / Q000706:statistics & numerical data*; D009790:Occupations; D012051:Reimbursement Mechanisms; D012189:Retrospective Studies; D013038:Specialization
D001786:Blood Glucose; D006442:Glycated Hemoglobin