Social inequalities and outcomes in type 2 diabetes in the German region of Augsburg. A cross-sectional survey.
OBJECTIVE
To assess the association of socioeconomic position with health (care) outcomes in type 2 diabetes with a particular focus on glycaemic control.


METHODS
A cross-sectional survey in the region of Augsburg (Germany) on 373 men and women with type 2 diabetes, drawn from representative MONICA surveys and the myocardial infarct register. Analysis of association of socioeconomic position with HbAlc levels, cardiovascular risk factors and long-term macro- and microvascular diabetes complications using logistic regression models.


RESULTS
Glycaemic control, measured by HbAlc levels, is strongly associated with indicators of socioeconomic position favouring the better off. Comparison of the lowest with the highest socioeconomic group showed an odds ratio of 2.49 (95% CI: 1.22-5.07) for the MI register subgroup and 1.80 (95% CI: 0.80-4.06) for the survey subgroup for failure to achieve the recommended HbAlc target. This association could not be accounted for by differences across social groups in age, sex, diabetes duration, obesity, or physical activity.


CONCLUSIONS
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.
Reisig
Veronika
V
GSF--National Research Center for Environment and Health, Institute of Health Economics and Health Care Management, Neuherberg, Germany.
Reitmeir
Peter
P
Döring
Angela
A
Rathmann
Wolfgang
W
Mielck
Andreas
A
D000368:Aged; D002318:Cardiovascular Diseases / Q000209:etiology; D003430:Cross-Sectional Studies; D003627:Data Interpretation, Statistical; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000628:therapy*; D015444:Exercise; D005260:Female; D005858:Germany; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012307:Risk Factors; D012959:Socioeconomic Factors; D016896:Treatment Outcome
D006442:Glycated Hemoglobin