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Association between sociodemographic determinants and health outcomes in individuals with type 2 diabetes mellitus in Sweden.
Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Uppsala University.ORCID iD: 0000-0001-8682-2045
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2018 (English)In: Diabetes/Metabolism Research Reviews, ISSN 1520-7552, E-ISSN 1520-7560Article in journal (Refereed) Epub ahead of print
Abstract [en]

BACKGROUND: Concurrent multifactorial treatment is needed to reduce consequent risks of diabetes, yet most studies investigating the relationship between sociodemographic factors and health outcomes have focused on only one risk factor at a time. Swedish health care is mainly tax-funded, thus providing an environment that should facilitate equal health outcomes in patients, independent of background, socioeconomic status or health profile. This study aimed at investigating the association between several sociodemographic factors and diabetes-related health outcomes represented by HbA1c , systolic blood pressure, LDL cholesterol, predicted 5-year risk of cardiovascular disease as well as statin use.

METHODS: This large retrospective registry-study was based on patient-level data from individuals diagnosed with type 2 diabetes mellitus during 2010-2011 (n = 416,228) in any of seven Swedish regions (~65% of the Swedish population). Health equity in diabetes care was analyzed through multivariate regression analyses on intermediary outcomes (HbA1c , systolic blood pressure, LDL), predicted 5-year risk of cardiovascular disease and process (i.e. statin use) after one-year follow-up, adjusting for several sociodemographic factors.

RESULTS: We observed differences in intermediary risk measures, predicted 5-year risk of cardiovascular disease as well as process dependent on place of birth, sex, age, education and social setting, despite Sweden's articulated vision of equal health care.

CONCLUSIONS: Diabetes patients' health was associated with sociodemographic prerequisites. In addition to demographics (age, sex) and disease history; educational level, marital status and region of birth are important factors to consider when benchmarking health outcomes, e.g. average HbA1c level, between organizational units or between different administrative regions.

Place, publisher, year, edition, pages
2018.
Keyword [en]
HbA1c, Type 2 diabetes mellitus, cardiovascular disease, sociodemographics, statin use, systolic blood pressure
National Category
Health Sciences
Research subject
Health and Welfare
Identifiers
URN: urn:nbn:se:du-27115DOI: 10.1002/dmrr.2984PubMedID: 29377503OAI: oai:DiVA.org:du-27115DiVA: diva2:1180532
Available from: 2018-02-06 Created: 2018-02-06 Last updated: 2018-02-06Bibliographically approved

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Leksell, Janeth

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