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. 2011 May;34(5):1127-32.
doi: 10.2337/dc10-1862. Epub 2011 Mar 18.

Effect of socioeconomic status on mortality among people with type 2 diabetes: a study from the Scottish Diabetes Research Network Epidemiology Group

Jeremy J Walker  1 , Shona J Livingstone, Helen M Colhoun, Robert S Lindsay, John A McKnight, Andrew D Morris, John R Petrie, Sam Philip, Naveed Sattar, Sarah H Wild; Scottish Diabetes Research Network Epidemiology Group
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Effect of socioeconomic status on mortality among people with type 2 diabetes: a study from the Scottish Diabetes Research Network Epidemiology Group

Jeremy J Walker et al. Diabetes Care. 2011 May.

Abstract

Objective: The study objective was to describe the effect of socioeconomic status (SES) on mortality among people with type 2 diabetes.

Research design and methods: We used a population-based national electronic diabetes database for 35- to 84-year-olds in Scotland for 2001-2007 linked to mortality records. SES was derived from an area-based measure with Q5 and Q1 representing the most deprived and affluent quintiles, respectively. Poisson regression was used to estimate relative risks (RRs) for mortality among people with type 2 diabetes compared with the population without diabetes stratified by age (35-64 and 65-84 years), sex, duration of diabetes (< 2 and ≥ 2 years), and SES.

Results: Complete data were available for 210,994 eligible individuals (99.4%), and there were 33,842 deaths. Absolute mortality from all causes among people with type 2 diabetes increased with increasing age and socioeconomic deprivation and was higher for men than women. RR for mortality associated with type 2 diabetes was highest for women aged 35-64 years in Q1 with diabetes duration < 2 years at 4.83 (95% CI 3.15-7.40) and lowest for men aged 65-84 years in Q5 with diabetes duration ≥ 2 years at 1.13 (1.03-1.24).

Conclusions: SES modifies the association between type 2 diabetes and mortality so that RR for mortality is lower among more deprived populations. Age, sex, and duration of diabetes also interact with type 2 diabetes to influence RR of mortality. Differences in prevalence of comorbidities may explain these findings.

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Figures

Figure 1
Figure 1
Age-standardized prevalence (and 95% CI) for type 2 diabetes for 35- to 84-year-olds by sex and quintile of SIMD (1 = most affluent, 5 = most deprived) for 2001 to 2007. formula image, Men; ■, women.
Figure 2
Figure 2
Age-standardized mortality for people with type 2 diabetes and for the population of Scotland without diabetes for 2001–2007 stratified by sex and duration of diabetes. □, General population (no diabetes); ●, type 2 diabetes.
See this image and copyright information in PMC

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