학술논문

Socioeconomic inequalities in type 2 diabetes mellitus: a study based on a population-based survey in Iran
Document Type
article
Source
BMC Public Health, Vol 24, Iss 1, Pp 1-9 (2024)
Subject
Socioeconomic inequality
Type 2 diabetes
Concentration index
Iran DiaCare
Public aspects of medicine
RA1-1270
Language
English
ISSN
1471-2458
Abstract
Abstract Background Type 2 diabetes mellitus (T2DM) is the most prevalent form of Diabetes Mellitus (DM), with social and economic determinants significantly influencing its prevalence. This study aimed to analyze the socioeconomic inequalities associated with T2DM in Iran. Methods Data from an observational survey in Iran, titled “Diabetes Care (DiaCare),” were utilized for this study. Socioeconomic inequalities were assessed through variables including Hemoglobin A1C (HbA1c), Fasting Blood Glucose (FBG), and Triple target (HbA1c, blood pressure, LDL-C), using concentration indices (CIs) and a multivariate logistic regression analysis. Individual socioeconomic status (SES) was determined by calculating an asset index using principle component analysis (PCA) based on their properties. Data analysis was conducted using STATA software version 14. Results A total of 13,321 participants were included in the study. The CIs were significantly positive for controlled HbA1c (0.0324) and triple target (0.1067), while for controlled FBG, it was 0.0125, although not significant. Among females, the CIs were significantly positive for controlled HbA1c (0.0745), FBG (0.0367), and triple target (0.209). Additionally, in the 45–55 and 65–75 age groups, the CIs were significantly positive for controlled HbA1c (0.0607) and FBG (0.0708), respectively. This index was significant for controlled Triple target in the 35–45 (0.376) and 65–75 (0.124) age groups. The CI for controlled FBG was significant in rural dwellers (-0.044) while the concentration of controlled triple target was significant in urban dwellers (0.0967). Controlled HbA1c showed significant concentration in both urban (0.0306) and rural (-0.0576) dwellers. Furthermore, the CIs were significant for controlled HbA1c in regions with medium prevalence (0.0534) and FBG in regions with low prevalence (-0.0277). This index was significantly positive for controlled triple target in regions with high prevalence (0.124). Conclusions Diabetes care is more concentrated among individuals with higher SES. Policymakers should consider this to mitigate the inequality and alleviate the burden of T2DM.