A decade of socioeconomic inequality in type 2 diabetes area-level prevalence: an unshakeable status quo?

2022 ◽  
pp. 140349482110623
Author(s):  
Ina Tapager ◽  
Anne Mette Bender ◽  
Ingelise Andersen
Keyword(s):  
Type 2 Diabetes ◽  
Socioeconomic Inequality ◽  
Socioeconomic Disadvantage ◽  
Socioeconomic Gradient ◽  
Time Period ◽  
Public Data ◽  
Welfare Systems ◽  
Index Of Inequality ◽  
Socioeconomic Composition

Aims: It is well known that there is a socioeconomic gradient in the prevalence of many chronic diseases, including type 2 diabetes (T2DM). We present a simple assessment of the macro-level association between area socioeconomic disadvantage and the area-level prevalence of T2DM in Danish municipalities and the development in this relationship over the last decade. Methods: We used readily available public data on the socioeconomic composition of municipalities and T2DM prevalence to illustrate this association and report the absolute and relative summary measures of socioeconomic inequality over the time period 2008–2018. Results: The results show a persistent relationship between municipality socioeconomic disadvantage and T2DM prevalence across all analyses, with a modelled gap in T2DM prevalence between the most and least disadvantaged municipalities, the slope index of inequality, of 1.23 [0.97;1.49] in 2018. Conclusions: These results may be used to indicate areas with specific needs, to encourage systematic monitoring of socioeconomic gradients in health, and to provide a descriptive backdrop for a discussion of how to tackle these socioeconomic and geographic inequalities, which seem to persist even in the context of the comprehensive welfare systems in Scandinavia.

scholarly journals Effectiveness of telephone interventions as a strategy for glycemic control: an integrative literature review

2013 ◽  
Vol 22 (1) ◽  
pp. 239-246 ◽  
Author(s):  
Hérica Cristina Alves de Vasconcelos ◽  
Roberto Wagner Júnior Freire de Freitas ◽  
Niciane Bandeira Pessoa Marinho ◽  
Marta Maria Coelho Damasceno ◽  
Thelma Leite de Araújo ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Literature Review ◽  
Self Management ◽  
Inclusion Criteria ◽  
Adult Type ◽  
Randomized Controlled Clinical Trials ◽  
Randomized Controlled ◽  
Time Period

The objective of this study was to analyze the effectiveness of telephone interventions as a strategy for glycemic control in adult Type 2 Diabetes Mellitus patients. An integrative literature review was undertaken in April and May 2011 through surveys in the Cochrane, PubMed/Medline, Lilacs and Cinahl databases. Nine studies complied with the inclusion criteria, mainly randomized controlled clinical trials. Concerning the time period analyzed in each study, it varied from eight weeks to twelve months. 1294 patients participated in the study, being 671 randomized to telephone follow-ups and 479 to usual care. In eight studies analyzed, glycemic control was based on the levels of glycated hemoglobin (HbA1c). The information found showed that the interventions are effective for glycemic control in patients who have type 2 Diabetes. Self-management was improved and possible complications of the disease were reduced.

What We Don’t Talk About When We Talk About Preventing Type 2 Diabetes—Addressing Socioeconomic Disadvantage

2016 ◽  
Vol 176 (8) ◽  
pp. 1053 ◽  
Author(s):  
Gabriela Spencer Bonilla ◽  
Rene Rodriguez-Gutierrez ◽  
Victor M. Montori
Keyword(s):  
Type 2 Diabetes ◽  
Socioeconomic Disadvantage

scholarly journals Diabetes and premature menopause: is their co-existence detrimental to the skeleton?

2005 ◽  
Vol 152 (3) ◽  
pp. 437-442 ◽  
Author(s):  
D J Hadjidakis ◽  
A M Mylonakis ◽  
M E Sfakianakis ◽  
A E Raptis ◽  
S A Raptis
Keyword(s):  
Type 2 Diabetes ◽  
Premature Menopause ◽  
Mineral Density ◽  
Duration Of Diabetes ◽  
Time Period ◽  
Menopausal Women ◽  
Significant Difference ◽  
Z Scores ◽  
Design And Methods

Objective: Premature menopause is a known risk factor for osteoporosis, whilst the influence of type 2 diabetes on bone mineral density (BMD) is still controversial. Design and methods: BMD values assessed by dual-energy X-ray absorptiometry (DXA) in L2–L4 vertebrae and the femoral neck (FN) of 40 diabetic women with premature menopause (D-EMP) were compared with those of 60 non-diabetic, prematurely menopausal women (EMP) and 60 diabetic women with normal menopause (D-NMP) who had been matched by age and body mass index (BMI). In all women, the time elapsed since menopause ranged between 10 and 25 years and the duration of diabetes exceeded 75% of the postmenopausal time period. The age of D-EMP women was 58.7±5 years (mean±1 s.d.), age at menopause 39.5±2.7, years since menopause 18.6±4.9, BMI 27.8±4.3 kg/m2 and duration of diabetes 13.9±3.9 years. Results: Vertebral BMD values of D-EMP women were significantly higher than those of EMP women (0.908±0.135 vs. 0.817±0.14 g/cm2, P = 0.002), although there was no significant difference between D-EMP and D-NMP women (0.886±0.15 g/cm2). No significant differences were observed in FN BMD values between all groups. Age-adjusted BMD values (Z scores) of D-EMP women were higher than EMP women in both anatomic sites (P < 0.01), but did not differ from D-NMP women. In contrast to the other two groups, no statistically significant correlation was observed in D-EMP women between the BMD values of either anatomic area and the time elapsed since menopause. HbA1c values were positively correlated only to vertebral BMD values of the D-EMP group (P < 0.05). No correlation was observed between the BMD values and the duration of diabetes either in D-EMP or in D-NMP women. Conclusions: Type 2 diabetes seems to positively affect the mineral density of the trabecular bone in women with premature menopause. The duration of diabetes does not appear to influence bone mass.

scholarly journals Efficacy of Ketogenic Diets on Type 2 Diabetes: a Systematic Review

2021 ◽  
Vol 21 (9) ◽  
Author(s):  
Delphine Tinguely ◽  
Justine Gross ◽  
Christophe Kosinski
Keyword(s):  
Type 2 Diabetes ◽  
Weight Loss ◽  
Causal Effect ◽  
Future Research ◽  
Mindful Eating ◽  
Ketogenic Diets ◽  
Time Period ◽  
Short Time

Abstract Purpose of Review To assess the pleiotropic effects of ketogenic diets (KD) on glucose control, changes in medication, and weight loss in individuals with type 2 diabetes, and to evaluate its practical feasibility Recent Findings KD results in improved HbA1c already after 3 weeks, and the effect seems to persist for at least 1 year. This is associated with a reduction in glucose-lowering medications. The weight loss observed after a short time period seems to be maintained with a long-term diet. Adequate support (supportive psychological counseling, enhancing positive affectivity, reinforcing mindful eating) is necessary to achieve a benefit and to assure adherence. Summary Despite the documented decrease in HbA1, a definitive causal effect of KD remains to be proven. KD should be performed under strict medical supervision. Future research should clarify how compliance can be maximized and how ketosis can be optimally monitored.

scholarly journals Self-reported hypoglycaemia in patients treated with insulin: A large Slovenian retrospectively-prospective study

2017 ◽  
Vol 56 (4) ◽  
pp. 244-250
Author(s):  
Draženka Pongrac Barlovič ◽  
Andrej Zavratnik ◽  
Aleš Skvarča ◽  
Karmen Janša ◽  
Bojana Vukelič ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Glycated Haemoglobin ◽  
Daily Basis ◽  
Hypoglycaemic Event ◽  
Major Barrier ◽  
Time Period ◽  
Randomised Control Trials ◽  
Comprehensive Study

Abstract Introduction Hypoglycaemia is the major barrier for glycaemic target achievement in patients treated with insulin. The aim of the present study was to investigate real-world incidence and predictors of hypoglycaemia in insulin-treated patients. Methods More than 300 consecutive patients with type 1 or type 2 diabetes treated with insulin were enrolled during regular out-patient visits from 36 diabetes practices throughout the whole country. They completed a comprehensive questionnaire on hypoglycaemia knowledge, awareness, and incidence in the last month and last six months. In addition, in the prospective part, patients recorded incidence of hypoglycaemic events using a special diary prospectively on a daily basis, through 4 weeks. Results At least one hypoglycaemic event was self-reported in 84.1%, and 56.4% of patients with type 1 and type 2 diabetes, respectively, during the prospective period of 4 weeks. 43.4% and 26.2% of patients with type 1 and type 2 diabetes, respectively, experienced a nocturnal hypoglycaemic event. In the same time-period, severe hypoglycaemia was experienced by 15.9% and 7.1% of patients with type 1 and type 2 diabetes, respectively. Lower glycated haemoglobin was not a significant predictor of hypoglycaemia. Conclusions Rates of self-reported hypoglycaemia in patients treated with insulin in the largest and most comprehensive study in Slovenia so far are higher than reported from randomised control trials, but comparable to data from observational studies. Hypoglycaemia incidence was high even with high glycated haemoglobin values.

scholarly journals Examining chronic pain through the lens of the socioeconomic gradient

2020 ◽  
Vol 11 (1) ◽  
pp. 144-147
Author(s):  
Christophe Tanguay-Sabourin
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Type 2 Diabetes ◽  
Chronic Pain ◽  
Socioeconomic Status ◽  
Pain Severity ◽  
Health Determinants ◽  
Optimal Care ◽  
Socioeconomic Gradient

Longstanding evidence reveals the existence of a gradient of health running along the socioeconomic spectrum. This is denoted by a graded association between health and levels of socioeconomic status, including factors such as gender, income, education, and occupational roles. This gradient is found across many chronic diseases including heart failure, arthritis, type 2 diabetes, ulcers, and certain cancers, all of which commonly possess debilitating pain diagnoses. Here, I examine chronic pain and its severity through the lens of this socioeconomic gradient across three perspectives along with their potential limitations. First, I discuss how this gradient represents risk factors for greater pain severity, disability, and comorbidity. Then, I explore potential underlying health determinants and how one’s position on this spectrum may predetermine their chance of receiving optimal care for their pain. Finally, I end with the prospect of better clinical and biological understanding of chronic pain severity with the inclusion of this socioeconomic gradient.

scholarly journals Examining the Association between Neighbourhood Socioeconomic Disadvantage and Type 2 Diabetes Comorbidity in Serious Mental Illness

2019 ◽  
Vol 16 (20) ◽  
pp. 3905 ◽  
Author(s):  
Ramya Walsan ◽  
Darren J Mayne ◽  
Xiaoqi Feng ◽  
Nagesh Pai ◽  
Andrew Bonney
Keyword(s):  
Type 2 Diabetes ◽  
Mental Illness ◽  
Geographic Variation ◽  
Serious Mental Illness ◽  
Socioeconomic Disadvantage ◽  
Logistic Regression Models ◽  
Disadvantaged Communities ◽  
Disadvantaged Neighbourhoods ◽  
Geographically Targeted

This study examined the association between neighbourhood socioeconomic disadvantage and serious mental illness (SMI)–type 2 diabetes (T2D) comorbidity in an Australian population using routinely collected clinical data. We hypothesised that neighbourhood socioeconomic disadvantage is positively associated with T2D comorbidity in SMI. The analysis considered 3816 individuals with an SMI living in the Illawarra and Shoalhaven regions of NSW, Australia, between 2010 and 2017. Multilevel logistic regression models accounting for suburb (neighbourhood) level clustering were used to assess the association between neighbourhood disadvantage and SMI -T2D comorbidity. Models were adjusted for age, sex, and country of birth. Compared with the most advantaged neighbourhoods, residents in the most disadvantaged neighbourhoods had 3.2 times greater odds of having SMI–T2D comorbidity even after controlling for confounding factors (OR 3.20, 95% CI 1.42–7.20). The analysis also revealed significant geographic variation in the distribution of SMI -T2D comorbidity in our sample (Median Odds Ratio = 1.35) Neighbourhood socioeconomic disadvantage accounted for approximately 17.3% of this geographic variation. These findings indicate a potentially important role for geographically targeted initiatives designed to enhance prevention and management of SMI–T2D comorbidity in disadvantaged communities.

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