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Education, immigration and income as risk factors for hemoglobin A1c >70 mmol/mol when diagnosed with type 2 diabetes or latent autoimmune diabetes in adult: a population-based cohort study
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.ORCID iD: 0000-0002-4140-1981
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
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2017 (English)In: BMJ Open Diabetes Research and Care, Vol. 5, no 1Article in journal (Refereed) Published
Abstract [en]

Objectives The aim of this research is to study education, income and immigration as risk factors for high hemoglobin A1c (HbA1c &gt;70 mmol/mol (8.6%)) when diagnosed with type 2 diabetes (T2D) or latent autoimmune diabetes in the adult (LADA).Research design and methods Patients were included from the All New Diabetics in Scania study (2008-2013). Level of education, disposable income and immigration year were retrieved from the longitudinal integrated database for labour market research (LISA) register compiled by Statistics Sweden. Logistic regression models were used to estimate ORs for HbA1c &gt;70 mmol/mol (8.6%) at diagnosis.Results A total of 3794 patients with incident T2D (n=3 525) or LADA (n=269) were included. Patients with T2D with a low (<=9 years) or medium (10-12 years) levels of education were more likely to have high HbA1c at diagnosis compared with patients with T2D with a high (&gt;12 years) level of education (OR 1.34, 95% CI 1.08 to1.66, OR 1.26, 95% CI 1.03 to 1.54). Low-income patients with T2D (&lt;60% of median) were more likely to have high HbA1c at diagnosis compared with high-income patients withT2D (&gt;150% of median) (OR 1.35, 95% CI 1.02 to 1.79).Conclusions Patients with lower levels of education or low income and are more likely to have HbA1c is &gt;70 mmol/mol (8.6%) when diagnosed with T2D. An understanding of how socioeconomic position influences the clinical presentation at diagnosis may facilitate screening programs designed to target populations at risk for delayed diagnosis.

Place, publisher, year, edition, pages
BMJ Specialist Journals , 2017. Vol. 5, no 1
National Category
Public Health, Global Health, Social Medicine and Epidemiology Endocrinology and Diabetes
Identifiers
URN: urn:nbn:se:uu:diva-321637DOI: 10.1136/bmjdrc-2016-000346OAI: oai:DiVA.org:uu-321637DiVA: diva2:1096521
Available from: 2017-05-18 Created: 2017-05-18 Last updated: 2017-05-18

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Publisher's full texthttp://drc.bmj.com/content/5/1/e000346

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