Department of Global Health Entrepreneurship, Division of Public Health, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
Department of Population Science and Human Resource Development, University of Rajshahi, Rajshahi, 6205, Bangladesh.
Sci Rep. 2020 Apr 21;10(1):6690. doi: 10.1038/s41598-020-63253-8.
Although low socioeconomic status (SES) is related to poor glycemic control, the underlying mechanisms remain unclear. We examined potentially modifiable factors involved in the association between low SES and poor glycemic control using data from the baseline survey of a multicenter, prospective cohort study. Five hundred adult type 2 diabetes patients were recruited from three diabetes centers. Glycemic control was poorer in diabetic individuals with low SES than in those with higher SES. Adverse health-related behaviors, such as non-adherence to medication (adjusted odds ratio [AOR] = 1.07, 95% confidence interval [CI] 1.04-1.13) and diet (AOR = 1.04, 95% CI 1.02-1.06); existing comorbidities, such as depressive symptoms (AOR = 1.05, 95% CI 1.04-1.09); and non-adherence to essential health service-related practices concerning diabetes care, such as irregular scheduled clinic visits (AOR = 1.04, 95% CI 1.03-1.06) and not practicing self-monitoring of blood glucose (AOR = 1.05, 95% CI 1.03-1.07), mediated the relationship between social adversity and poor glycemic control specially in urban areas of Bangladesh. Those identified factors provide useful information for developing interventions to mitigate socioeconomic disparities in glycemic control.
尽管社会经济地位（SES）较低与血糖控制不佳有关，但其中的潜在机制仍不清楚。我们利用多中心前瞻性队列研究基线调查的数据，研究了 SES 较低与血糖控制不佳之间关联中涉及的潜在可调节因素。从三个糖尿病中心招募了 500 名成年 2 型糖尿病患者。SES 较低的糖尿病患者的血糖控制较差，而 SES 较高的患者则较好。不良的与健康相关的行为，如不遵医嘱（调整后的优势比[OR] = 1.07，95%置信区间[CI] 1.04-1.13）和饮食（OR = 1.04，95% CI 1.02-1.06）；现有的合并症，如抑郁症状（OR = 1.05，95% CI 1.04-1.09）；以及不遵守有关糖尿病护理的基本卫生服务相关实践，如不定期预约诊所就诊（OR = 1.04，95% CI 1.03-1.06）和不进行自我血糖监测（OR = 1.05，95% CI 1.03-1.07），在孟加拉国的城市地区，这些因素特别介导了社会逆境与血糖控制不佳之间的关系。这些确定的因素为制定干预措施提供了有用的信息，以减轻血糖控制方面的社会经济差异。
