Department of Public Health, Faculty of Medicine, Semmelweis University, Budapest, Hungary.
Department of Internal Medicine and Oncology, Faculty of Medicine, Semmelweis University, Budapest, Hungary.
Front Endocrinol (Lausanne). 2024 May 1;15:1299148. doi: 10.3389/fendo.2024.1299148. eCollection 2024.
Low socioeconomic status affects not only diagnosis rates and therapy of patients with diabetes mellitus but also their health behavior. Our primary goal was to examine diagnosis rates and therapy of individuals with diabetes living in Ormánság, one of the most deprived areas in Hungary and Europe. Our secondary goal was to examine the differences in lifestyle factors and cancer screening participation of patients with diagnosed and undiagnosed diabetes compared to healthy participants.
Our study is a cross-sectional analysis using data from the "Ormánság Health Program". The "Ormánság Health Program" was launched to improve the health of individuals in a deprived region of Hungary. Participants in the program were coded as diagnosed diabetes based on diagnosis by a physician as a part of the program, self-reported diabetes status, and self-reported prescription of antidiabetic medication. Undiagnosed diabetes was defined as elevated blood glucose levels without self-reported diabetes and antidiabetic prescription. Diagnosis and therapeutic characteristics were presented descriptively. To examine lifestyle factors and screening participation, patients with diagnosed and undiagnosed diabetes were compared to healthy participants using linear regression or multinomial logistic regression models adjusted for sex and age.
Our study population consisted of 246 individuals, and 17.9% had either diagnosed (n=33) or undiagnosed (n=11) diabetes. Metformin was prescribed in 75.8% (n=25) of diagnosed cases and sodium-glucose cotransporter-2 inhibitors (SGLT-2) in 12.1% (n=4) of diagnosed patients. After adjustment, participants with diagnosed diabetes had more comorbidities (adjusted [aOR]: 3.50, 95% confidence interval [95% CI]: 1.34-9.18, p<0.05), consumed vegetables more often (aOR: 2.49, 95% CI: 1.07-5.78, p<0.05), but desserts less often (aOR: 0.33, 95% CI: 0.15-0.75, p<0.01) than healthy individuals. Patients with undiagnosed diabetes were not different in this regard from healthy participants. No significant differences were observed for cancer screening participation between groups.
To increase recognition of diabetes, targeted screening tests should be implemented in deprived regions, even among individuals without any comorbidities. Our study also indicates that diagnosis of diabetes is not only important for the timely initiation of therapy, but it can also motivate individuals in deprived areas to lead a healthier lifestyle.
社会经济地位低下不仅影响糖尿病患者的诊断率和治疗效果，还影响他们的健康行为。我们的主要目标是检查生活在奥曼萨格（匈牙利和欧洲最贫困地区之一）的糖尿病患者的诊断率和治疗情况。我们的次要目标是检查诊断和未诊断的糖尿病患者与健康参与者在生活方式因素和癌症筛查参与方面的差异。
我们的研究是一项使用“奥曼萨格健康计划”数据的横断面分析。“奥曼萨格健康计划”的目的是改善匈牙利贫困地区人们的健康。该计划中的参与者被编码为患有糖尿病，依据是医生的诊断、自我报告的糖尿病状况和自我报告的抗糖尿病药物处方。未诊断的糖尿病定义为血糖升高但无自我报告的糖尿病和抗糖尿病药物处方。诊断和治疗特征以描述性方式呈现。为了检查生活方式因素和筛查参与情况，我们使用线性回归或多项逻辑回归模型将患有诊断和未诊断糖尿病的患者与健康参与者进行比较，并根据性别和年龄进行调整。
我们的研究人群由 246 人组成，17.9%的人患有已诊断（n=33）或未诊断（n=11）的糖尿病。在已诊断的病例中，有 75.8%（n=25）的人服用二甲双胍，12.1%（n=4）的人服用钠-葡萄糖共转运蛋白 2 抑制剂（SGLT-2）。调整后，患有糖尿病的参与者有更多的合并症（调整后的优势比[aOR]：3.50，95%置信区间[95%CI]：1.34-9.18，p<0.05），更常食用蔬菜（aOR：2.49，95%CI：1.07-5.78，p<0.05），但较少食用甜点（aOR：0.33，95%CI：0.15-0.75，p<0.01）。未诊断的糖尿病患者在这方面与健康参与者没有差异。各组之间的癌症筛查参与率没有显著差异。
为了提高对糖尿病的认识，即使在没有任何合并症的人群中，也应在贫困地区实施有针对性的筛查试验。我们的研究还表明，糖尿病的诊断不仅对及时开始治疗很重要，而且还可以激励贫困地区的个人过上更健康的生活方式。
