Socioeconomic position and cardiovascular risk factors among people with screen-detected Type 2 DM: Six-year follow-up of the ADDITION-Denmark trial |
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| Affiliation: | 1. Department of Public Health, Section for General Practice, Aarhus University, Denmark;2. Research Unit for General Practice, Aarhus University, Denmark;3. Department of Public Health, Section for Health Promotion and Health Services, Denmark;4. Holbaek Hospital, Region Zealand, Denmark;1. Center for Health Services Research in Primary Care, Durham VA Medical Center, Durham, NC;2. Department of Medicine, Division of Endocrinology, Diabetes, and Metabolism, Duke University, Durham, NC;3. Eshelman School of Pharmacy, University of North Carolina, Chapel Hill;4. Hunter Holmes McGuire Veterans Affairs Medical Center, Richmond, Va;5. Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, NC;6. Department of Medicine, Division of General Internal Medicine, Duke University, Durham, NC;1. Department of Cardiology and Acute Internal Medicine, Central Hospital, Karlstad, Sweden;2. Faculty of Health Sciences and Medicine, Örebro University, Örebro, Sweden;3. Department of Medical Sciences, Uppsala University, Uppsala, Sweden;4. Endocrine and Diabetes Center, Central Hospital, Karlstad, Sweden;5. Statistical Unit, Värmland County Council, Karlstad, Sweden;6. Department of Medicine, Clinical Epidemiological Unit, Karolinska Institute, Stockholm, Sweden;7. Department of Clinical Sciences, Lund University, Skåne University Hospital, Malmö, Sweden;1. Department of Chemical Engineering, National Research Tomsk Polytechnic University, 30, Lenin Avenue, Tomsk, 634050, Russia;2. Department of Processes and Equipment for Food Production, 650056, Russia, Kemerovo, Institute of Food Science and Technology, Boulevard Stroiteley, 47;1. Department of Pediatrics, University of Colorado Denver and Children''s Hospital Colorado, Aurora, CO;2. Western Psychiatric Institute and Clinic, University of Pittsburgh, Pittsburgh, PA;3. Rainbow Babies and Children''s Hospital, University Hospitals Case Medical Center, Cleveland, OH;4. Baylor College of Medicine, Houston, TX;5. George Washington University Biostatistics Center, Rockville, MD;6. Children''s Hospital Los Angeles, Los Angeles, CA;7. Children''s Hospital of Philadelphia, Philadelphia, PA;8. Rainbow Babies and Children''s Hospital, Case Western Reserve University, Cleveland, OH;9. State University of New York Upstate Medical University, Syracuse, NY;10. George Washington University Biostatistics Center, Rockville, MD;11. Department of Pediatrics, Division of Endocrinology & Metabolism, Children''s Hospital Los Angeles, Los Angeles CA;1. Federal State Institution of Petroleum Chemistry Institute, Siberian Branch of the Russian Academy of Sciences, Tomsk, Akademichesky ave., 4, Tomsk, 634021, Russia;2. National Research Tomsk Polytechnic University, 634050, Lenina ave., 30, Tomsk, Russian Federation |
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| Abstract: | AimsTo examine whether socioeconomic position (SEP) was associated with change in cardiovascular risk factors and meeting treatment targets for cardiovascular risk factors among individuals with screen-detected Type 2 DM at six-year follow-up.MethodsThe study population was 1533 people with Type 2 DM identified from at stepwise diabetes screening programme in general practice during 2001–2006 in the ADDITION-Denmark study. The ADDITION-study was performed as a randomised trial but the two randomisation groups were analysed as one cohort in this study. Cardiovascular risk factors were measured at baseline and repeated at follow-up (mean: 5.9 [1.4] years). Information on SEP, redeemed antihypertensive and lipid-lowering treatment were obtained from Danish registers. Multivariate analyses were performed to estimate change in cardiovascular risk factors and difference in meeting treatment targets.ResultsThe change in HbA1c, cholesterol, blood pressure and BMI were virtually the same across educational level, income level, occupational status or cohabiting status. Overall, the ability to meet treatment targets for HbA1c, cholesterol and blood pressure was not modified by SEP-group. A higher proportion of people with lower educational level or lower income level in the intensive care redeemed anti-hypertensive treatment compared to people with higher educational or income levels.ConclusionScreen-detection and early treatment onset did not introduce socioeconomic inequality in metabolic control in people with screen-detected Type 2 DM at six-year follow-up. |
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| Keywords: | Type 2 diabetes mellitus Cardiovascular risk factors Socioeconomic position General practice |
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