Abstract
ObjectiveTo assess the relationship between socioeconomic status (SES) and complications of type 2 diabetes among young adults in Japan.DesignA cross-sectional study.SettingOutpatient wards of 96 member hospitals and clinics of the Japan Federation of Democratic Medical Institutions.ParticipantsA total of 782 outpatients with type 2 diabetes (525 males, 257 females), aged 20–40 years as of March 31, 2012. After excluding 110 participants whose retinopathy diagnosis was in question, 672 participants were analyzed.MeasurementsWe examined the relations between SES (educational level, income, type of public healthcare insurance, and employment status) and diabetes complications (retinopathy and nephropathy) using a multivariate logistic regression analysis.ResultsThe prevalence of type 2 diabetic retinopathy was 23.2%, while that of nephropathy was 8.9%. The odds of having retinopathy were higher among junior high school graduates (OR 1.91, 95% CI 1.09–3.34), patients receiving public assistance (OR 2.19, 95% CI 1.20–3.95), and patients with irregular (OR 1.72, 95% CI 1.03–2.86) or no employment (OR 2.23, 95% CI 1.36–3.68), compared to those with a higher SES, even after covariate adjustment (e.g., age, gender, body mass index). Similarly, the odds of having nephropathy were higher among patients with middle (OR 3.61, 95% CI 1.69–8.27) or low income levels (OR 2.53, 95% CI 1.11–6.07), even after covariate adjustment.ConclusionsLow SES was associated with a greater likelihood of type 2 diabetes complications in young adults. These findings suggest the necessity of health policies that mitigate socioeconomic disparity and thereby reduce the prevalence of diabetic complications.
Highlights
Diabetes is a chronic disease with serious complications
We examined the relations between socioeconomic status (SES) and diabetes complications using a multivariate logistic regression analysis
The odds of having retinopathy were higher among junior high school graduates, patients receiving public assistance, and patients with irregular or no employment, compared to those with a higher SES, even after covariate adjustment
Summary
Two major complications of T2DM are retinopathy and nephropathy, which are a significant cause of blindness and end-stage renal diseases (ESRD), respectively. In recent years, there has been a notable increase in evidence for a relationship between socioeconomic status (SES) and T2DM [2, 4,5,6]. There have still been comparatively few investigations of the relationship between SES and T2DM complications [5], and those that have been conducted showed no consistency in terms of the relevance of SES to retinopathy or nephropathy caused by T2DM. T2DM complications are a heavy burden, both for the individuals affected and for society, in terms of quality of life and medical costs. It is clear that a greater understanding of the relationship between SES and T2DM complications must be obtained
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