Diabetes prevalence and association with social status--widening of a social gradient? German national health surveys 1990-1992 and 1998.
BACKGROUND
Widening of social inequality in health is often discussed. Data regarding trends of the association between diabetes prevalence and social status are lacking.


METHODS
Using two German health surveys (age 25-69 years), we estimated diabetes prevalences in 1998 compared to 1990-1992. Interaction of secular time with educational level, adjusted for age and BMI, were estimated in men and women using multiple regression models, considering the sample design.


RESULTS
Diabetes prevalences in 1990-1992 and 1998 were 5.1% (95% CI 4.1-6.0) and 4.3% (3.5-5.1) in men, and 4.7% (4.0-5.4) and 3.8% (3.0-4.6) in women. It was significantly higher in older subjects and in obese subjects, and tended to be higher in lower educated subjects. Overall, prevalence tended to be lower in 1998 compared to 1990-1992, however, not statistically significant after adjustment for education and BMI (odds ratio, 95% CI: men 0.73; 0.39-1.37; women 0.41; 0.17-1.03). On a descriptive level, in the lowest education group, the diabetes prevalence was higher in 1998 compared to 1990-1992, whereas, it has decreased in higher educated subjects. However, confidence intervals were large, and we found no statistically significant interaction between calendar year and the educational level.


CONCLUSIONS
Diabetes prevalence tended to decrease in Germany during the 1990s. A widening of social disparity in diabetes risk might be present, but a significant increase could not be confirmed.
Icks
Andrea
A
Institute of Biometrics and Epidemiology, German Diabetes Center, Leibniz Institute at Heinrich Heine University, Auf'm Hennekamp 65, 40225 Düsseldorf, Germany. icks@ddz.uni-duesseldorf.de
Moebus
Susanne
S
Feuersenger
Astrid
A
Haastert
Burkhard
B
Jöckel
Karl-Heinz
KH
Giani
Guido
G
D000328:Adult; D000368:Aged; D003920:Diabetes Mellitus / Q000453:epidemiology*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012923:Social Class