Socioeconomic position and cardiovascular risk factors among people with screen-detected Type 2 DM: six-year follow-up of the ADDITION-Denmark trial

Prim Care Diabetes. 2014 Dec;8(4):322-9. doi: 10.1016/j.pcd.2014.01.006. Epub 2014 Mar 6.

Abstract

Aims: To examine whether socioeconomic position (SEP) was associated with change in cardiovascular risk factors and meeting treatment targets for cardiovascular risk factors among individuals with screen-detected Type 2 DM at six-year follow-up.

Methods: The study population was 1533 people with Type 2 DM identified from at stepwise diabetes screening programme in general practice during 2001-2006 in the ADDITION-Denmark study. The ADDITION-study was performed as a randomised trial but the two randomisation groups were analysed as one cohort in this study. Cardiovascular risk factors were measured at baseline and repeated at follow-up (mean: 5.9 [1.4] years). Information on SEP, redeemed antihypertensive and lipid-lowering treatment were obtained from Danish registers. Multivariate analyses were performed to estimate change in cardiovascular risk factors and difference in meeting treatment targets.

Results: The change in HbA1c, cholesterol, blood pressure and BMI were virtually the same across educational level, income level, occupational status or cohabiting status. Overall, the ability to meet treatment targets for HbA1c, cholesterol and blood pressure was not modified by SEP-group. A higher proportion of people with lower educational level or lower income level in the intensive care redeemed anti-hypertensive treatment compared to people with higher educational or income levels.

Conclusion: Screen-detection and early treatment onset did not introduce socioeconomic inequality in metabolic control in people with screen-detected Type 2 DM at six-year follow-up.

Trial registration: ClinicalTrials.gov NCT00237549.

Keywords: Cardiovascular risk factors; General practice; Socioeconomic position; Type 2 diabetes mellitus.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Antihypertensive Agents / therapeutic use
  • Biomarkers / blood
  • Blood Pressure
  • Body Mass Index
  • Cardiovascular Diseases / diagnosis
  • Cardiovascular Diseases / epidemiology*
  • Cardiovascular Diseases / prevention & control
  • Chi-Square Distribution
  • Cholesterol / blood
  • Comorbidity
  • Denmark / epidemiology
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / diagnosis
  • Diabetes Mellitus, Type 2 / drug therapy
  • Diabetes Mellitus, Type 2 / epidemiology*
  • Dyslipidemias / blood
  • Dyslipidemias / drug therapy
  • Dyslipidemias / epidemiology
  • Educational Status
  • Female
  • General Practice
  • Glycated Hemoglobin A / metabolism
  • Health Status Disparities*
  • Humans
  • Hypertension / drug therapy
  • Hypertension / epidemiology
  • Hypertension / physiopathology
  • Hypoglycemic Agents / therapeutic use
  • Hypolipidemic Agents / therapeutic use
  • Income
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Obesity / epidemiology
  • Obesity / physiopathology
  • Registries
  • Risk Factors
  • Socioeconomic Factors*
  • Time Factors

Substances

  • Antihypertensive Agents
  • Biomarkers
  • Glycated Hemoglobin A
  • Hypoglycemic Agents
  • Hypolipidemic Agents
  • hemoglobin A1c protein, human
  • Cholesterol

Associated data

  • ClinicalTrials.gov/NCT00237549