Sociodemographic disparities in non-diabetic hyperglycaemia and the transition to type 2 diabetes: evidence from the English Longitudinal Study of Ageing
AuthorChatzi, G; Mason, T; Chandola, T; Whittaker, W; Howarth, E; Cotterill, S; Ravindrarajah, R; McManus, E; Sutton, M; Bower, P
Source TitleDiabetic Medicine
University of Melbourne Author/sSutton, Matthew
AffiliationMelbourne Institute of Applied Economic and Social Research
Document TypeJournal Article
CitationsChatzi, G., Mason, T., Chandola, T., Whittaker, W., Howarth, E., Cotterill, S., Ravindrarajah, R., McManus, E., Sutton, M. & Bower, P. (2020). Sociodemographic disparities in non-diabetic hyperglycaemia and the transition to type 2 diabetes: evidence from the English Longitudinal Study of Ageing. Diabetic Medicine, 37 (9), pp.1536-1544. https://doi.org/10.1111/dme.14343.
Access StatusOpen Access
Aim To explore whether there are social inequalities in non‐diabetic hyperglycaemia (NDH) and in transitions to type 2 diabetes mellitus and NDH low‐risk status in England. Methods Some 9143 men and women aged over 50 years were analysed from waves 2, 4, 6 and 8 (2004–2016) of the English Longitudinal Study of Ageing (ELSA). Participants were categorized as: NDH ‘low‐risk’ [HbA1c < 42 mmol/mol (< 6.0%)], NDH [HbA1c 42–47 mmol/mol (6.0–6.4%)] and type 2 diabetes [HbA1c > 47 mmol/mol (> 6.4%)]. Logistic regression models estimated the association between sociodemographic characteristics and NDH, and the transitions from NDH to diagnosed or undiagnosed type 2 diabetes and low‐risk status in future waves. Results NDH was more prevalent in older participants, those reporting a disability, those living in deprived areas and in more disadvantaged social classes. Older participants with NDH were less likely to progress to undiagnosed type 2 diabetes [odds ratio (OR) 0.27, 95% confidence interval (CI) 0.08, 0.96]. NDH individuals with limiting long‐standing illness (OR 1.72, 95% CI 1.16, 2.53), who were economically inactive (OR 1.60, 95% CI 1.02, 2.51) or from disadvantaged social classes (OR 1.63, 95% CI 1.02, 2.61) were more likely to progress to type 2 diabetes. Socially disadvantaged individuals were less likely (OR 0.64, 95% CI 0.41, 0.98) to progress to NDH low‐risk status. Conclusions There were socio‐economic differences in NDH prevalence, transition to type 2 diabetes and transition to NDH low‐risk status. Disparities in transitions included the greater likelihood of disadvantaged social groups with NDH developing type 2 diabetes and greater likelihood of advantaged social groups with NDH becoming low‐risk. These socio‐economic differences should be taken into account when targeting prevention initiatives.
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