Sociodemographic determinants and health outcome variation in individuals with type 1 diabetes mellitus: A register-based study

BackgroundSocioeconomic status, origin or demographic attributes shall not determine the quality of healthcare delivery, according to e.g. United Nations and European Union rules. Health equity has been defined as the absence of systematic disparities and unwarranted differences between groups defined by differences in social advantages. A study was performed to investigate whether this was applicable to type 1 diabetes mellitus (T1D) care in a setting with universal, tax-funded healthcare.MethodsThis retrospective registry-study was based on patient-level data from individuals diagnosed with T1D during 2010–2011 (n = 16,367) in any of seven Swedish county councils (covering ~65% of the Swedish population). Health equity in T1D care was analysed through multivariate regression analyses on absolute HbA1c level at one-year follow-up, one-year change in estimated glomerular filtration rate (eGFR) and one-year change in cardiovascular risk score, using selected sociodemographic dimensions as case-mix factors.ResultsHigher educational level was consistently associated with lower levels of HbA1c, and so was being married. Never married was associated with worse eGFR development, and lower educational level was associated with higher cardiovascular risk. Women had higher HbA1c levels than men, and glucose control was significantly worse in patients below the age of 25.ConclusionPatients’ sociodemographic profile was strongly associated with absolute levels of risk factor control in T1D, but also with an increased annual deterioration in eGFR. Whether these systematic differences stem from patient-related problems or healthcare organisational shortcomings is a matter for further research. The results, though, highlight the need for intensified diabetes management education and secondary prevention directed towards T1D patients, taking sociodemographic characteristics into account.

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PID https://www.doi.org/10.1371/journal.pone.0199170
URL https://figshare.com/articles/Sociodemographic_determinants_and_health_outcome_variation_in_individuals_with_type_1_diabetes_mellitus_A_register-based_study/6725729
URL http://dx.doi.org/10.1371/journal.pone.0199170
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Author Willers, Carl
Author Iderberg, Hanna
Author Axelsen, Mette
Author Dahlström, Tobias
Author Julin, Bettina
Author Leksell, Janeth
Author Lindberg, Agneta
Author Lindgren, Peter
Author Muth, Karin Looström
Author Svensson, Ann-Marie
Author Lilja, Mikael
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Collected From figshare
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Publication Date 2018-01-01
Publisher Figshare
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Source https://science-innovation-policy.openaire.eu/search/dataset?datasetId=r37980778c78::dbc70809460bf8d37b643911114eb67a
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Last Updated 15 December 2020, 21:35 (CET)
Created 15 December 2020, 21:35 (CET)