Diabetes research and clinical practice · 2025
Gender and socioeconomic inequalities in the cascade of type 2 diabetes care trends among middle-aged and older Chinese.
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Yi Qian, Luo Zeyu, Sun Weidi, Shan Shiyi, Ying Jiayao, Wu Jing, Song Peige
Аннотация
AIMS: Gender and socioeconomic disparities are key determinants influencing the burden and management of type 2 diabetes mellitus (T2DM). This study examined how gender and socioeconomic inequalities influence trends across the T2DM care cascade in China.
METHODS: Data were drawn from five waves (2011-2020) of the China Health and Retirement Longitudinal Study (CHARLS; N = 11,059-14,789). The care cascade included four stages: prevalence, awareness, treatment, and control. Multivariable logistic regressions estimated adjusted odds ratios (aORs) for gender and socioeconomic status (SES). Inequalities were assessed using the slope index (SII), relative index (RII), and concentration index (CIX).
RESULTS: Firstly, T2DM prevalence rose from 12.8 % to 22.4 % in women and 12.0 % to 21.5 % in men, with women having higher odds (aOR: 1.09-1.17). Secondly, awareness increased over time, particularly among women (aOR: 1.18-1.31). Thirdly, over 60 % of patients remained untreated, with persistent SES disparities. Fourthly, control rates showed little gender or SES difference. Socioeconomic inequalities narrowed in awareness but widened in women's treatment (RII: 1.22-1.45).
CONCLUSIONS: Rising T2DM prevalence, persistent SES disparities, and widening gender gaps highlight the need for targeted interventions-particularly for women, low-SES individuals, and treatment-stage improvement.
METHODS: Data were drawn from five waves (2011-2020) of the China Health and Retirement Longitudinal Study (CHARLS; N = 11,059-14,789). The care cascade included four stages: prevalence, awareness, treatment, and control. Multivariable logistic regressions estimated adjusted odds ratios (aORs) for gender and socioeconomic status (SES). Inequalities were assessed using the slope index (SII), relative index (RII), and concentration index (CIX).
RESULTS: Firstly, T2DM prevalence rose from 12.8 % to 22.4 % in women and 12.0 % to 21.5 % in men, with women having higher odds (aOR: 1.09-1.17). Secondly, awareness increased over time, particularly among women (aOR: 1.18-1.31). Thirdly, over 60 % of patients remained untreated, with persistent SES disparities. Fourthly, control rates showed little gender or SES difference. Socioeconomic inequalities narrowed in awareness but widened in women's treatment (RII: 1.22-1.45).
CONCLUSIONS: Rising T2DM prevalence, persistent SES disparities, and widening gender gaps highlight the need for targeted interventions-particularly for women, low-SES individuals, and treatment-stage improvement.