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Socio‐economic differences in cardiovascular disease risk factor prevalence in people with type 2 diabetes in Scotland: a cross‐sectional study
Author(s) -
Whittaker E.,
Read S. H.,
Colhoun H. M.,
Lindsay R. S.,
McGurnaghan S.,
McKnight J. A.,
Sattar N.,
Wild S. H.
Publication year - 2020
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/dme.14297
Subject(s) - medicine , type 2 diabetes , odds ratio , diabetes mellitus , cross sectional study , population , risk factor , demography , confidence interval , logistic regression , body mass index , blood pressure , endocrinology , environmental health , pathology , sociology
Aim To describe the association between socio‐economic status and prevalence of key cardiovascular risk factors in people with type 2 diabetes in Scotland. Methods A cross‐sectional study of 264 011 people with type 2 diabetes in Scotland in 2016 identified from the population‐based diabetes register. Socio‐economic status was defined using quintiles of the area‐based Scottish Index of Multiple Deprivation (SIMD) with quintile (Q)1 and Q5 used to identify the most‐ and least‐deprived fifths of the population, respectively. Logistic regression models adjusted for age, sex, health board, history of cardiovascular disease and duration of diabetes were used to estimate odds ratios (ORs) for Q1 compared with Q5 for each risk factor. Results The mean ( sd ) age of the study population was 66.7 (12.8) years, 56% were men, 24% were in Q1 and 15% were in Q5. Crude prevalence in Q1/Q5 was 24%/8.8% for smoking, 62%/49% for BMI ≥ 30 kg/m 2 , 44%/40% for HbA 1c ≥ 58 mmol/mol (7.5%), 31%/31% for systolic blood pressure (SBP) ≥ 140 mmHg, and 24%/25% for total cholesterol ≥ 5 mmol/l, respectively. ORs [95% confidence intervals (CI)] were 3.08 (2.95–3.21) for current smoking, 1.48 (1.44–1.52) for BMI ≥ 30 kg/m 2 , 1.11 (1.08–1.15) for HbA 1c ≥ 58 mmol/mol (7.5%), 1.03 (1.00–1.06) for SBP ≥ 140 mmHg and 0.87 (0.84–0.90) for total cholesterol ≥ 5 mmol/l. Conclusions Socio‐economic deprivation is associated with higher prevalence of smoking, BMI ≥ 30 kg/m 2 and HbA 1c ≥ 58 mmol/mol (7.5%), and lower prevalence of total cholesterol ≥ 5 mmol/l among people with type 2 diabetes in Scotland. Effective approaches to reducing inequalities are required as well as reducing risk factor prevalence across the whole population.