TY - JOUR
T1 - Educational inequalities in clinical presentation and pharmacological treatment of early type 2 diabetes
T2 - A Danish prevalence study
AU - Sørensen, Marie T
AU - Kristensen, Frederik P B
AU - Nielsen, Jens S
AU - Christensen, Diana H
AU - Nicolaisen, Sia K
AU - Beck-Nielsen, Henning
AU - Vestergaard, Peter
AU - Jessen, Niels
AU - Olsen, Michael H
AU - Hansen, Torben
AU - Vaag, Allan
AU - Sørensen, Henrik T
AU - Thomsen, Reimar W
N1 - Copyright © 2025 The Author(s). Published by Elsevier B.V. All rights reserved.
PY - 2025/5/15
Y1 - 2025/5/15
N2 - AIMS: To examine how educational attainment impacts clinical presentation and pharmacological treatment at type 2 diabetes (T2D) diagnosis.METHODS: Cross-sectional analysis of 10,020 individuals with recently diagnosed T2D enrolled in the Danish prospective DD2 cohort. Sex- and age-adjusted prevalence ratios (aPRs) for detailed clinical characteristics and pharmacotherapy were computed.RESULTS: In total, 31 % had low, 50 % had moderate, and 19 % had high educational level. Individuals with low rather than high educational level were more often obese (58 % vs 49 %, aPR 1.20 [95 % CI 1.14-1.28]); had less healthy lifestyles (current smokers: 22 % vs 15 %, aPR 1.53 [1.32-1.76]); sedentary activity level: 21 % vs 15 %, aPR 1.36 [1.20-1.55]); and had more often cardiovascular (23 % vs. 17 %, PR 1.30 [1.16-1.46]) and microvascular complications (16 % vs 13 %, aPR 1.18 [1.02-1.35]). Low education associated with higher triglycerides, more insulin resistance, and poorer kidney function, whereas HbA1c, blood pressure, and LDL cholesterol were identical. The use of medications with cardiovascular benefits and newer organ-protective diabetes medications was similar to, or higher than, that in individuals with high education.CONCLUSIONS: Awareness of the impact of social and educational determinants on T2D presentation at diagnosis is essential to improve treatment and prognosis.
AB - AIMS: To examine how educational attainment impacts clinical presentation and pharmacological treatment at type 2 diabetes (T2D) diagnosis.METHODS: Cross-sectional analysis of 10,020 individuals with recently diagnosed T2D enrolled in the Danish prospective DD2 cohort. Sex- and age-adjusted prevalence ratios (aPRs) for detailed clinical characteristics and pharmacotherapy were computed.RESULTS: In total, 31 % had low, 50 % had moderate, and 19 % had high educational level. Individuals with low rather than high educational level were more often obese (58 % vs 49 %, aPR 1.20 [95 % CI 1.14-1.28]); had less healthy lifestyles (current smokers: 22 % vs 15 %, aPR 1.53 [1.32-1.76]); sedentary activity level: 21 % vs 15 %, aPR 1.36 [1.20-1.55]); and had more often cardiovascular (23 % vs. 17 %, PR 1.30 [1.16-1.46]) and microvascular complications (16 % vs 13 %, aPR 1.18 [1.02-1.35]). Low education associated with higher triglycerides, more insulin resistance, and poorer kidney function, whereas HbA1c, blood pressure, and LDL cholesterol were identical. The use of medications with cardiovascular benefits and newer organ-protective diabetes medications was similar to, or higher than, that in individuals with high education.CONCLUSIONS: Awareness of the impact of social and educational determinants on T2D presentation at diagnosis is essential to improve treatment and prognosis.
U2 - 10.1016/j.diabres.2025.112231
DO - 10.1016/j.diabres.2025.112231
M3 - Journal article
C2 - 40381656
SN - 0168-8227
VL - 225
SP - 112231
JO - Diabetes Research and Clinical Practice
JF - Diabetes Research and Clinical Practice
ER -