1426-P: Socioeconomic Disparities in Mortality among Young Adults with Diabetes—A Nationwide Cohort Study in South Korea

Abstract

Objectives: This study aimed to estimate the overall and cause-specific mortality risk according to socioeconomic status (SES) and age among patients with diabetes. Research Design and Methods: From the Korean National Health Insurance Service Cohort (2008-2019), 1,240,780 adults aged 20-79 years (604,975 patients with diabetes and 635,805 controls without diabetes) were included. The risk of mortality from any causes, cardiovascular disease, diabetes, and cancer was estimated according to the patients’ SES and compared with age- and sex-matched controls without diabetes. The SES was categorized into three groups (tercile) by subjects’ income. Subgroup analyses were done according to the individuals’ age group (20-39, 40-59, and 60-79 years). Results: Overall, 48,420 deaths occurred during a follow-up. Compared with individuals without diabetes, the adjusted hazard ratios (HR) of all-cause mortality of patients with diabetes were 1.25 (95% confidence interval (CI), 1.23-1.28) in the highest SES, 1.56 (95% CI, 1.53-1.59) in the middle SES, and 1.78 (95% CI, 1.74-1.82) in the lowest SES group. The inverse relationship between SES and mortality risk was prominent in younger patients; the HRs of all-cause mortality in the lowest SES group were 4.00 (95% CI, 3.25-4.93) in patients aged 20-39 years, 2.71 (95% CI, 2.59-2.84) in those aged 40-59 years, and 1.58 (95% CI, 1.54-1.62) in those aged 60-79 years. A similar association was observed in cause-specific mortality. Conclusion: Low SES increased the risks of all-cause mortality and mortality from cardiovascular disease, diabetes, and cancer in patients with diabetes. This association is more prominent in younger patients than in older patients. Disclosure J.Kim: None. N.Kim: None. S.Kim: None.