Rincon Oswaldo, Uscategui Catalina, Mancera Pedro, Luna Maria, Rodriguez Alba, Alvarez Mauricio, Guzman Isaac
Department of Endocrinology, Hospital Militar Central, Bogota 110221, Colombia.
Department of Epidemiology, Hospital Militar Central, Bogota 110221, Colombia.
World J Diabetes. 2025 Aug 15;16(8):106927. doi: 10.4239/wjd.v16.i8.106927.
Social determinants of health are social and economic factors that influence health intervention outcomes. Type 2 diabetes is a highly prevalent disease, primarily affecting individuals in low-to-middle-income countries. However, the association between social determinants and cardiovascular complications in type 2 diabetes has not been widely studied.
To examine the relationship between social determinants of health and cardiovascular complications in individuals with type 2 diabetes.
We conducted a retrospective cohort study with an analytical component at a national-level referral hospital for military personnel in Bogota, Colombia. Patients treated at the diabetes clinic between September 2021 and December 2022 who met the inclusion criteria were included. A total of 583 patients participated in the study. We performed descriptive, bivariate, and binary logistic regression analyses, adjusting for confounding variables.
Among the 583 patients included, urban residency [odds ratio (OR) = 3.05, 95% confidence interval (CI): 1.01-9.20] and a middle or high educational level (OR = 2.33, 95%CI: 1.14-4.72) were associated with an increased risk of coronary artery disease. Additionally, receiving diabetes education beyond that provided by the clinic (OR = 2.15, 95%CI: 1.14-4.05) and lack of access to spaces for physical activity (OR = 4.05, 95%CI: 1.31-12.5) were associated with a higher risk of diabetic nephropathy and cerebrovascular disease, respectively.
Programs for diabetes management should account for social determinants of health that contribute to cardiovascular complications and increased healthcare costs. Population-based studies are needed to guide targeted interventions and clarify causal relationships.
健康的社会决定因素是影响健康干预结果的社会和经济因素。2型糖尿病是一种高度流行的疾病，主要影响低收入和中等收入国家的人群。然而，社会决定因素与2型糖尿病心血管并发症之间的关联尚未得到广泛研究。
研究2型糖尿病患者健康的社会决定因素与心血管并发症之间的关系。
我们在哥伦比亚波哥大的一家国家级军事人员转诊医院进行了一项带有分析成分的回顾性队列研究。纳入了2021年9月至2022年12月期间在糖尿病诊所接受治疗且符合纳入标准的患者。共有583名患者参与了该研究。我们进行了描述性、双变量和二元逻辑回归分析，并对混杂变量进行了调整。
在纳入的583名患者中，城市居住[比值比（OR）=3.05，95%置信区间（CI）：1.01-9.20]和中等或高教育水平（OR =2.33，95%CI：1.14-4.72）与冠状动脉疾病风险增加相关。此外，接受诊所以外的糖尿病教育（OR =2.15，95%CI：1.14-4.05）和缺乏体育活动空间（OR =4.05，95%CI：1.31-12.5）分别与糖尿病肾病和脑血管疾病的较高风险相关。
糖尿病管理项目应考虑到导致心血管并发症和医疗成本增加的健康社会决定因素。需要开展基于人群的研究来指导有针对性的干预措施并阐明因果关系。
