title: Type 2 diabetes incidence and socio-economic position: a systematic review and meta-analysis.
abstract: BACKGROUND
  We conducted a systematic review and meta-analysis, the first to our knowledge, summarizing and quantifying the published evidence on associations between type 2 diabetes incidence and socio-economic position (SEP) (measured by educational level, occupation and income) worldwide and when sub-divided into high-, middle- and low-income countries.
  
  
  METHODS
  Relevant case-control and cohort studies published between 1966 and January 2010 were searched in PubMed and EMBASE using the keywords: diabetes vs educational level, occupation or income. All identified citations were screened by one author, and two authors independently evaluated and extracted data from relevant publications. Risk estimates from individual studies were pooled using random-effects models quantifying the associations.
  
  
  RESULTS
  Out of 5120 citations, 23 studies, including 41 measures of association, were found to be relevant. Compared with high educational level, occupation and income, low levels of these determinants were associated with an overall increased risk of type 2 diabetes; [relative risk (RR) = 1.41, 95% confidence interval (CI): 1.28-1.51], (RR = 1.31, 95% CI: 1.09-1.57) and (RR = 1.40, 95% CI: 1.04-1.88), respectively. The increased risks were independent of the income levels of countries, although based on limited data in middle- and low-income countries.
  
  
  CONCLUSIONS
  The risk of getting type 2 diabetes was associated with low SEP in high-, middle- and low-income countries and overall. The strength of the associations was consistent in high-income countries, whereas there is a strong need for further investigation in middle- and low-income countries.
authors.affiliation: Department of Public Health Sciences, Division of Social Medicine, Karolinska Institutet, Stockholm, Sweden. emilie.agardh@ki.se
authors.forename: Emilie
authors.initials: E
authors.lastname: Agardh
authors.forename: Peter
authors.initials: P
authors.lastname: Allebeck
authors.forename: Johan
authors.initials: J
authors.lastname: Hallqvist
authors.forename: Tahereh
authors.initials: T
authors.lastname: Moradi
authors.forename: Anna
authors.initials: A
authors.lastname: Sidorchuk
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D016022:Case-Control Studies; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000503:physiopathology*; D004522:Educational Status; D005260:Female; D014943:Global Health; D006801:Humans; D008297:Male; D008875:Middle Aged; D009790:Occupations / Q000639:trends; D011203:Poverty; D015995:Prevalence; D018570:Risk Assessment; D017678:Sex Distribution; D012959:Socioeconomic Factors; D013548:Sweden