Association between the economic situation and diabetes mellitus, metabolic control and the use of health services in a Spanish region

Abstract

IntroductionThe prevalence of diabetes mellitus (DM) has increased in low- and middle-income countries and in marginal areas of developed countries. In Spain, it grew by 3.42% from 1993 to 2020. In the Canary Islands, the increase was even greater. ObjectivesThe main one was to evaluate the possible relationship of the income level with DM, different markers of metabolic control and the use of Primary Care services, in Las Palmas de Gran Canaria (LPGC). Secondary ones are to determine the prevalence of DM in the city of LPGC, to describe the sociodemographic characteristics, the use of Primary Care services of the population with DM, the level of registry of variables related to metabolic control and the main process indicators and intermediate results of the metabolic control in the population with DM in the city of LPGC. Material and methodAll patients with DM over 14 years of age, living in LPGC as of 12/31/22 were included. Data were collected from the electronic medical records of the Canarian Primary Care Service, the National Institute of Statistics and the National Tax Agency. Results and conclusionThe overall prevalence of DM was 11.39%. The mean age of participants was 67.06 years (SD=13.86), lower in men than in women. The groups with low or moderate income accounted for more than 40% of the prevalence each, while those with high income barely accounted for 10%. Higher income levels corresponded to lower use of health resources and registration of metabolic variables, while decreasing income levels were associated to higher prevalence of overweight/obesity, worse lipid and glycemic profiles and higher risk of diabetic foot. The middle-income group showed the highest prevalence of pathological/uncertain diabetic retinopathy, lower glomerular filtration and higher LDL levels.