title: Association between socioeconomic status and metabolic control and diabetes complications: a cross-sectional nationwide study in Chinese adults with type 2 diabetes mellitus.
abstract: BACKGROUND
  Low socioeconomic status (SES) is associated with adverse cardiovascular risk factor patterns and poor outcomes in patients with diabetes. The aim of this study was to determine whether SES is associated with the control of blood glucose, blood pressure, blood cholesterol (3Bs), and diabetic complications in Chinese adults with type 2 diabetes.
  
  
  METHODS
  Data regarding patients' demographics, social economics, diabetes complications, and cardiovascular risk profiles were analyzed for 25,454 patients. The outcomes of interest were the proportions of patients with HbA1c <7.0 %, blood pressure <140/80 mmHg, total serum cholesterol <4.5 mmol/L, and diabetes complications. Multivariable logistic regression was used for analysis.
  
  
  RESULTS
  Of the 25,454 patients, the least educated patients (1695, 6.7 %) had the highest chances of developing cardiovascular diseases (p = 0.048), cerebrovascular diseases (p < 0.001), and retinopathy (p < 0.001). The patients with lowest household income (10,039, 40.8 %) had the highest prevalence of retinopathy (p < 0.001) and neuropathy (p < 0.001). The most educated patients were more likely than the least educated patients to achieve HbA1c <7.0 % [adjusted odds ratio (OR) 1.38; 95 % confidence interval (95 % CI) 1.22-1.56] and 3B goals (adjusted OR 1.30; 95 % CI 1.11-1.53). The patients with highest household income were more likely to achieve BP < 140/80 mmHg (adjusted OR 1.16; 95 % CI 1.07-1.27), but less likely to reach HbA1c < 7.0 % (adjusted OR 0.90; 95 % CI 0.83-0.98) than those lowest income patients.
  
  
  CONCLUSIONS
  Low SES was associated with poor metabolic control and more diabetes complications in adult patients in China. Individual diabetes management based on the SES of patients is encouraged.
authors.affiliation: Department of Endocrinology, Huadong Hospital Affiliated to Fudan University, 221 yananxi road, Shanghai, 200040, China.
authors.forename: Xiaoming
authors.initials: X
authors.lastname: Tao
authors.affiliation: MSD China Holding Co., Ltd., Shanghai, China.
authors.forename: Jihu
authors.initials: J
authors.lastname: Li
authors.affiliation: MSD China Holding Co., Ltd., Shanghai, China.
authors.forename: Xiaolin
authors.initials: X
authors.lastname: Zhu
authors.affiliation: MSD China Holding Co., Ltd., Shanghai, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Zhao
authors.affiliation: Department of Endocrinology, Huadong Hospital Affiliated to Fudan University, 221 yananxi road, Shanghai, 200040, China. sunjiao6972@aliyun.com.
authors.forename: Jiao
authors.initials: J
authors.lastname: Sun
authors.affiliation: Department of Endocrinology and Metabolism, Peking University People's Hospital, Beijing, China. jiln@bjmu.edu.cn.
authors.forename: Linong
authors.initials: L
authors.lastname: Ji
authors.affiliation: Department of Cardiology, Peking University People's Hospital, Beijing, China.
authors.forename: Dayi
authors.initials: D
authors.lastname: Hu
authors.affiliation: Department of Endocrinology, The Chinese PLA General Hospital, Beijing, China.
authors.forename: Changyu
authors.initials: C
authors.lastname: Pan
authors.affiliation: Department of Endocrinology, Huadong Hospital Affiliated to Fudan University, 221 yananxi road, Shanghai, 200040, China.
authors.forename: Yuxin
authors.initials: Y
authors.lastname: Huang
authors.affiliation: Department of Endocrinology, Huadong Hospital Affiliated to Fudan University, 221 yananxi road, Shanghai, 200040, China.
authors.forename: Suyuan
authors.initials: S
authors.lastname: Jiang
authors.affiliation: Department of Endocrinology, Huadong Hospital Affiliated to Fudan University, 221 yananxi road, Shanghai, 200040, China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Feng
authors.affiliation: Department of Endocrinology, Huadong Hospital Affiliated to Fudan University, 221 yananxi road, Shanghai, 200040, China.
authors.forename: Cuiping
authors.initials: C
authors.lastname: Jiang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure / Q000502:physiology*; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000453:epidemiology* / Q000378:metabolism*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012923:Social Class
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin
keywords: Blood glucose; Blood lipids; Blood pressure; Diabetes complications; Socioeconomic status; Type 2 diabetes