Diabetes research and clinical practice · 2026
Quantifying the impact of inequality on traditional and emerging diabetes complications: A registry study of cause-specific hospital admissions and deaths in Australia.
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Morton Jedidiah I, Williams Emily D, Shaw Jonathan E, Magliano Dianna J
Аннотация
BACKGROUND AND AIMS: Our aim was to quantify the relationship of a large range of diabetes complications with socioeconomic disadvantage.
METHODS: This study included 621,114 people with type 2 diabetes from the Australian National Diabetes Services Scheme, with follow-up from July 2010 to June 2022. These data were linked to hospital admission and death datasets. The association of socioeconomic disadvantage with cause-specific outcomes (first occurrence of either admission or death) was assessed using Poisson regression, adjusted for age, sex, and year.
RESULTS: Most diabetes-related complications studied were positively associated with increasing socioeconomic disadvantage, with the highest incidence rate ratios per 1-SD increase in socioeconomic disadvantage for admission or death from chronic obstructive pulmonary disease (1.19 (95%CI: 1.18, 1.21)) myocardial infarction (1.12 (1.11, 1.13)), heart failure (1.11 (1.10, 1.12)), cellulitis (1.10 (1.09, 1.12)), and end-stage kidney disease (1.09 (1.07, 1.12)). Foot complications and respiratory diseases showed a positive association with disadvantage, as did cardiovascular and kidney diseases, while most cancers, depression, and dementia did not.
CONCLUSIONS: Increasing socioeconomic disadvantage was associated with an increased risk of admission or death from most traditional diabetes-related complications and for respiratory disease. However, the associations with emerging complications of diabetes were weaker, null, or the risk decreased with increasing disadvantage.
METHODS: This study included 621,114 people with type 2 diabetes from the Australian National Diabetes Services Scheme, with follow-up from July 2010 to June 2022. These data were linked to hospital admission and death datasets. The association of socioeconomic disadvantage with cause-specific outcomes (first occurrence of either admission or death) was assessed using Poisson regression, adjusted for age, sex, and year.
RESULTS: Most diabetes-related complications studied were positively associated with increasing socioeconomic disadvantage, with the highest incidence rate ratios per 1-SD increase in socioeconomic disadvantage for admission or death from chronic obstructive pulmonary disease (1.19 (95%CI: 1.18, 1.21)) myocardial infarction (1.12 (1.11, 1.13)), heart failure (1.11 (1.10, 1.12)), cellulitis (1.10 (1.09, 1.12)), and end-stage kidney disease (1.09 (1.07, 1.12)). Foot complications and respiratory diseases showed a positive association with disadvantage, as did cardiovascular and kidney diseases, while most cancers, depression, and dementia did not.
CONCLUSIONS: Increasing socioeconomic disadvantage was associated with an increased risk of admission or death from most traditional diabetes-related complications and for respiratory disease. However, the associations with emerging complications of diabetes were weaker, null, or the risk decreased with increasing disadvantage.