The rate of new diabetes diagnosis is inversely related to income, a new study has shown. “There was a 20% higher risk of diabetes in the lowest 2 income groups compared with the highest group, which translated into an extra 2500 diagnoses of diabetes for that year.”
Lorraine Lipscombe, MD, from the University of Toronto, Ontario, added that, “Diabetes rates are increasing dramatically across all groups, and what we are finding is that those who are most socially disadvantaged are experiencing the greatest burden.”
Many previous studies have looked at the prevalence of diabetes across income groups, but the effect of income on diabetes incidence — actual new diagnosis — is less well understood, say Zoe Lysy, MD, from the University of Toronto, and colleagues in their paper. “We were isolating the risk more than the prevalence,” Dr. Lipscombe noted. “We also looked at whether these disparities could be explained by differences in diabetes screening, and we did not see that, so this is more a reflection of true risk,” she said.
“We found no differences in screening across income groups, but physicians should be aware that lower-income groups may be at higher risk of diabetes and ensure that they are getting screening early and being offered early preventive counseling if they have risk factors.
“We know from previous work that once lower-income populations get diabetes, they have worse outcomes, and this is a bigger problem in the younger population than the older one. So we also need greater attention to issues such as access and affordability of diabetes medications and access to diabetes education services once people get diabetes.”
Lysy and colleagues used a population-based diabetes registry and census data from Ontario. They compared rates of new diabetes cases among persons aged 20 years and older between April 1, 2006, and March 31, 2007, between neighborhood income quintiles and assessed for age- and sex-based differences.
The majority of diabetes would have been type 2, given that they examined an adult population, Dr. Lipscombe said, but she noted that they were unable to distinguish between types 1 and type 2 because the database just lists diabetes. “We may have picked up some new type 1 diabetes diagnosis between the age of 20 and 30,” she noted.
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