title: Social disparities in diabetes care: a general population study in Denmark.
abstract: OBJECTIVE
  We investigated the association between socioeconomic factors and the attainment of treatment goals and pharmacotherapy in patients with type 2 diabetes in Denmark.
  
  
  METHODS
  A cross-sectional population study.
  
  
  METHODS
  The municipality of Naestved, Denmark.
  
  
  METHODS
  We studied 907 patients with type 2 diabetes identified from a random sample of 21,205 Danish citizens.
  
  
  METHODS
  The proportion of patients who were not achieving goals for diabetes care based on their HbA1c, LDL-cholesterol, blood pressure, and lifestyle, and the proportion of patients who were treated with antihypertensive and cholesterol- and glucose-lowering medication.
  
  
  METHODS
  We investigated the association of the socioeconomic factors such as age, gender, education, occupation, income, and civil status and attainment of treatment goals and pharmacotherapy in logistic regression analyses. We investigated effect modification of cardiovascular disease and kidney disease.
  
  
  RESULTS
  Middle age (40-65 years), low education level (i.e. basic schooling), and low household income (i.e. less than 21,400 € per year) were associated with nonattainment of goals for diabetes care. The association of socioeconomic factors with attainment of individual treatment goals varied. Patients with low socioeconomic status were more often obese, physically inactive, smoking, and had elevated blood pressure. Socioeconomic factors were not associated with treatment goals for hyperglycemia. Socioeconomic factors were inconsistently associated with pharmacotherapy. There was no difference in contacts to general practitioners according to SES.
  
  
  CONCLUSIONS
  In a country with free access to health care, the socioeconomic factors such as middle age, low education, and low income were associated with nonattainment of goals for diabetes care. KEY POINTS Middle age, low education, and low income were associated with nonattainment of goals for diabetes care, especially for lifestyle goals. Patients with low socioeconomic status were more often obese, physically inactive, smoking, and had elevated blood pressure. Association of socioeconomic factors with pharmacotherapy was inconsistent.
authors.affiliation: a Section of General Practice, Department of Public Health and Research Unit for General Practice , Copenhagen University , Copenhagen , Denmark.|b The General Population Study , Nykøbing Falster Hospital , Nykøbing Falster, Denmark.
authors.forename: Andreas
authors.initials: A
authors.lastname: Heltberg
authors.affiliation: a Section of General Practice, Department of Public Health and Research Unit for General Practice , Copenhagen University , Copenhagen , Denmark.
authors.forename: John Sahl
authors.initials: JS
authors.lastname: Andersen
authors.affiliation: a Section of General Practice, Department of Public Health and Research Unit for General Practice , Copenhagen University , Copenhagen , Denmark.
authors.forename: Jakob
authors.initials: J
authors.lastname: Kragstrup
authors.affiliation: a Section of General Practice, Department of Public Health and Research Unit for General Practice , Copenhagen University , Copenhagen , Denmark.
authors.forename: Volkert
authors.initials: V
authors.lastname: Siersma
authors.affiliation: a Section of General Practice, Department of Public Health and Research Unit for General Practice , Copenhagen University , Copenhagen , Denmark.
authors.forename: Håkon
authors.initials: H
authors.lastname: Sandholdt
authors.affiliation: b The General Population Study , Nykøbing Falster Hospital , Nykøbing Falster, Denmark.|c Department of Laboratory Medicine , Boston Children's Hospital Study , Boston , MA , USA.|d Department of Clinical Medicine, Faculty of Health and Medical Sciences , University of Copenhagen , Copenhagen , Denmark.|e Department of Production , Research, and Innovation, Region Zealand , Sorø , Denmark.
authors.forename: Christina
authors.initials: C
authors.lastname: Ellervik
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000924:Anticholesteremic Agents / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000097:blood / Q000150:complications / Q000188:drug therapy; D003430:Cross-Sectional Studies; D003718:Denmark; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000188:drug therapy / Q000628:therapy*; D004522:Educational Status; D005260:Female; D058006:General Practice; D006442:Glycated Hemoglobin / Q000378:metabolism; D006040:Goals; D054625:Healthcare Disparities; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007182:Income; D008019:Life Style; D008297:Male; D008875:Middle Aged; D012923:Social Class
chemical_list: D000924:Anticholesteremic Agents; D000959:Antihypertensive Agents; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents
keywords: Denmark; Type 2 diabetes mellitus; general practice; health care; lifestyle; socioeconomic status