title: Association of low educational status with microvascular complications in type 2 diabetes: Jaipur diabetes registry.
abstract: OBJECTIVE
  To determine the association of educational status (ES), as marker of socioeconomic status, with the prevalence of microvascular complications in diabetes.
  
  
  METHODS
  Successive patients (n = 1214) presenting to our center were evaluated for sociodemographic, anthropometric, clinical, and therapeutic variables. Subjects were classified according to ES into Group 1 (illiterate, 216); Group 2 (≤ primary, 537), Group 3 (≤ higher secondary, 312), and Group 4 (any college, 149). Descriptive statistics is reported.
  
  
  RESULTS
  Mean age of patients was 52 ± 10 years, duration of diabetes 7 ± 7 years and 55% were men. Prevalence of various risk factors was smoking/tobacco 25.5%, obesity body mass index ≥25 kg/m(2) 64.0%, abdominal obesity 63.4%, hypertension 67.5%, high fat diet 14.5%, low fruits/vegetables 31.8%, low fiber intake 60.0%, high salt diet 16.9%, physical inactivity 27.5%, coronary or cerebrovascular disease 3.0%, and microvascular disease (peripheral, ocular or renal) in 20.7%. Microvascular disease was significantly greater in illiterate (25.9%) and low (23.6%) compared to middle (15.0%) and high (14.7%) ES groups (P < 0.05). Age- and sex-adjusted logistic regression analysis revealed that in illiterate and low ES groups respectively, prevalence of smoking/tobacco use (odds ratio 3.84, confidence interval: 09-7.05 and 2.15, 1.36-3.41); low fruit/vegetable (2.51, 1.53-4.14 and 1.99, 1.30-3.04) and low fiber intake (4.02, 2.50-6.45 and 1.78, 1.23-2.59) was greater compared to high ES. Poor diabetes control (HbA1c >.0%) was significantly greater in illiterate (38.0%), low (46.0%), and middle (41.0%) compared to high (31.5%) ES subjects (P < 0.05).
  
  
  CONCLUSIONS
  There is a greater prevalence of the microvascular disease in illiterate and low ES diabetes patients in India. This is associated with the higher prevalence of smoking/tobacco use, poor quality diet, and sub-optimal diabetes control.
authors.affiliation: Department of Medicine, Mahatma Gandhi Medical College and Hospital, Jaipur, Rajasthan, India.
authors.forename: Niharikaa
authors.initials: N
authors.lastname: Sharma
authors.affiliation: Department of Endocrinology, Galaxy Specialty Centre, Jaipur, Rajasthan, India.
authors.forename: Surendra Kumar
authors.initials: SK
authors.lastname: Sharma
authors.affiliation: Department of Medicine, Mahatma Gandhi Medical College and Hospital, Jaipur, Rajasthan, India.
authors.forename: Vitthal D
authors.initials: VD
authors.lastname: Maheshwari
authors.affiliation: Department of Medicine, Fortis Escorts Hospital, Jaipur, Rajasthan, India.
authors.forename: Krishna Kumar
authors.initials: KK
authors.lastname: Sharma
authors.affiliation: Department of Medicine, Fortis Escorts Hospital, Jaipur, Rajasthan, India.
authors.forename: Rajeev
authors.initials: R
authors.lastname: Gupta
keywords: Education status; HbA1c levels; microvascular complications; type 2 diabetes