title: Relation of socio-economic status to impaired fasting glucose and Type 2 diabetes: findings based on a large population-based cross-sectional study in Tianjin, China.
abstract: OBJECTIVE
  Studies on the relationship between socio-economic status and Type 2 diabetes mellitus in the Chinese population are sparse. We aimed to examine the relation of socio-economic status as represented by income, education and occupation to impaired fasting glucose, Type 2 diabetes, and the control of Type 2 diabetes in a large Chinese population.
  
  
  METHODS
  This study included 7315 individuals who were aged 20-79 years and living in Tianjin, China. Impaired fasting glucose and Type 2 diabetes were ascertained according to the 1999 World Health Organization criteria. Data were analysed using multinomial and binary logistic regression, with adjustment for potential confounders.
  
  
  RESULTS
  Among all participants, 532 (7.3%) persons had impaired fasting glucose, 688 (9.4%) persons had Type 2 diabetes, including 288 (3.9%) previously undiagnosed Type 2 diabetes. In fully adjusted multinomial logistic regression, compared with higher income (≥ 2000 yuan, $243.3/month), lower income (< 1000 yuan, $121.70/month) showed odds ratios (95% confidence intervals) of 3.31 (2.48-4.41) for impaired fasting glucose, 4.50 (3.07-6.61) for undiagnosed Type 2 diabetes and 4.56 (3.20-6.48) for diagnosed Type 2 diabetes. These results remained significant in the analysis stratified by education and occupation. Furthermore, persons who were retired were more likely to have impaired fasting glucose [odds ratio 1.91 (1.40-2.45)], undiagnosed Type 2 diabetes [odds ratio 2.01) 1.40-2.89] and diagnosed Type 2 diabetes [odds ratio 3.02 (2.12-4.22)]. Among the patients with Type 2 diabetes previously diagnosed, lower education (less than senior high school), non-manual work and unemployment were related to worse glycaemic control (fasting blood glucose level > 8.5 mmol/l).
  
  
  CONCLUSIONS
  Lower income and retirement are associated with increased odds of impaired fasting glucose and Type 2 diabetes in Tianjin, China. Education and occupation may play a role in glycaemic control among patients with Type 2 diabetes.
authors: Department of Epidemiology, School of Public Health, Tianjin Medical University, Tianjin, China.
authors: H
authors: H
authors: Zhang
authors: W
authors: W
authors: Xu
authors: A K
authors: AK
authors: Dahl
authors: Z
authors: Z
authors: Xu
authors: H-X
authors: HX
authors: Wang
authors: X
authors: X
authors: Qi
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000175:diagnosis / Q000191:economics / Q000453:epidemiology; D004522:Educational Status; D005215:Fasting; D005247:Feeding Behavior; D005260:Female; D018149:Glucose Intolerance / Q000097:blood* / Q000175:diagnosis / Q000191:economics / Q000453:epidemiology; D006442:Glycated Hemoglobin / Q000378:metabolism*; D007722:Health Knowledge, Attitudes, Practice; D057220:Health Literacy; D006801:Humans; D007182:Income; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009790:Occupations; D015995:Prevalence; D012307:Risk Factors; D012923:Social Class
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human