Heltberg Andreas, Andersen John Sahl, Kragstrup Jakob, Siersma Volkert, Sandholdt Håkon, Ellervik Christina
a Section of General Practice, Department of Public Health and Research Unit for General Practice , Copenhagen University , Copenhagen , Denmark.
b The General Population Study , Nykøbing Falster Hospital , Nykøbing Falster, Denmark.
Scand J Prim Health Care. 2017 Mar;35(1):54-63. doi: 10.1080/02813432.2017.1288702. Epub 2017 Mar 3.
We investigated the association between socioeconomic factors and the attainment of treatment goals and pharmacotherapy in patients with type 2 diabetes in Denmark.
A cross-sectional population study.
The municipality of Naestved, Denmark.
We studied 907 patients with type 2 diabetes identified from a random sample of 21,205 Danish citizens.
The proportion of patients who were not achieving goals for diabetes care based on their HbA, LDL-cholesterol, blood pressure, and lifestyle, and the proportion of patients who were treated with antihypertensive and cholesterol- and glucose-lowering medication.
We investigated the association of the socioeconomic factors such as age, gender, education, occupation, income, and civil status and attainment of treatment goals and pharmacotherapy in logistic regression analyses. We investigated effect modification of cardiovascular disease and kidney disease.
Middle age (40-65 years), low education level (i.e. basic schooling), and low household income (i.e. less than 21,400 € per year) were associated with nonattainment of goals for diabetes care. The association of socioeconomic factors with attainment of individual treatment goals varied. Patients with low socioeconomic status were more often obese, physically inactive, smoking, and had elevated blood pressure. Socioeconomic factors were not associated with treatment goals for hyperglycemia. Socioeconomic factors were inconsistently associated with pharmacotherapy. There was no difference in contacts to general practitioners according to SES.
In a country with free access to health care, the socioeconomic factors such as middle age, low education, and low income were associated with nonattainment of goals for diabetes care. KEY POINTS Middle age, low education, and low income were associated with nonattainment of goals for diabetes care, especially for lifestyle goals. Patients with low socioeconomic status were more often obese, physically inactive, smoking, and had elevated blood pressure. Association of socioeconomic factors with pharmacotherapy was inconsistent.
我们调查了丹麦2型糖尿病患者的社会经济因素与治疗目标达成情况及药物治疗之间的关联。
一项横断面人群研究。
丹麦奈斯特韦市。
我们对从21205名丹麦公民的随机样本中识别出的907例2型糖尿病患者进行了研究。
根据糖化血红蛋白、低密度脂蛋白胆固醇、血压和生活方式，未达到糖尿病护理目标的患者比例，以及接受抗高血压、降胆固醇和降糖药物治疗的患者比例。
我们在逻辑回归分析中调查了年龄、性别、教育程度、职业、收入和婚姻状况等社会经济因素与治疗目标达成情况及药物治疗之间的关联。我们研究了心血管疾病和肾脏疾病的效应修正。
中年（40 - 65岁）、低教育水平（即基础教育）和低家庭收入（即每年低于21400欧元）与未达到糖尿病护理目标相关。社会经济因素与个体治疗目标达成情况的关联各不相同。社会经济地位低的患者更常肥胖、身体不活动、吸烟且血压升高。社会经济因素与高血糖治疗目标无关。社会经济因素与药物治疗的关联不一致。根据社会经济地位，与全科医生的接触情况没有差异。
在一个可免费获得医疗保健的国家，中年、低教育和低收入等社会经济因素与未达到糖尿病护理目标相关。要点：中年、低教育和低收入与未达到糖尿病护理目标相关，尤其是生活方式目标。社会经济地位低的患者更常肥胖、身体不活动、吸烟且血压升高。社会经济因素与药物治疗的关联不一致。
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