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Diabetes

Session: Poster Session B

(036) Association of educational level with clinical presentation and pharmacological treatment in 10,020 individuals with recently diagnosed type 2 diabetes

Tuesday, August 27, 2024
8:00 AM – 6:00 PM CEST
Location: Convention Hall II

    Presenting Author(s)

  • Frederik P.B Kristensen, MD

    PhD student
    Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus N, Denmark.
    Aarhus N, Denmark

    • Co-Author(s)

  • MS

    Marie T. Sørensen

    Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus N, Denmark., Denmark

  • JN

    Jens S. Nielsen

    Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark., Denmark

  • DC

    Diana H. Christensen

    Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark, Denmark

  • SN

    Sia Kromann Nicolaisen

    Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus N, Denmark., Denmark

  • HB

    Henning Beck-Nielsen

    Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark., Denmark

  • PV

    Peter Vestergaard

    Steno Diabetes Center North Denmark, Aalborg, Denmark., Denmark

  • NJ

    Niels Jessen

    Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark., Denmark

  • MO

    Michael H. Olsen

    Cardiology Section, Department of Internal Medicine and Steno Diabetes Center Zealand, Holbæk Hospital, Holbæk, Denmark., Denmark

  • TH

    Torben Hansen

    Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Denmark, Denmark

  • AV

    Allan Vaag

    Lund University Diabetes Centre, Lund University, Sweden., Denmark

  • HS

    Henrik Toft Sørensen, MD, PhD, DMSc, DSc

    Professor & Chair
    Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus, Denmark, Denmark

  • Reimar W W. Thomsen, MD, PhD

    Professor and Consultant Physician
    Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital
    Aarhus, Denmark

Background: There is social inequality in the risk and prognosis of type 2 diabetes (T2D). Implementing optimal risk factor management and achieving disease control are crucial to prevent diabetes complications. It is unknown how the educational level affects early T2D presentation and treatment.

Objectives: To examine the clinical presentation and prophylactic pharmacological treatment by educational level in people with recently diagnosed T2D.

Methods: We designed a cross-sectional study of people with recently diagnosed T2D enrolled from general practice and hospital outpatient clinics between 2010 and 2021. Data was linked to Danish health registries. Highest achieved educational level at enrollment was grouped into low, medium, or high, based on the International Standard Classification of Education. We computed age- and sex-adjusted prevalence ratios (PRs) using Poisson regression.

Results: We included 10,020 individuals with a median age of 61 years, 42% were women, and the median diabetes duration was 1.2 years. In total, 31% had a low, 50% had a medium, and 19% had a high educational level. Compared to individuals with a high educational level, individuals with a low educational level were more often obese (58% vs 49%, PR 1.20 [95% CI 1.14-1.28]), current smokers (22% vs 15%, PR 1.53 [95% CI 1.32-1.76]), and had a low leisure-time physical activity level within the past year (21% vs 15%, PR 1.36 [95% CI 1.20-1.55]). Median HbA1c (48 mmol/mol) and LDL cholesterol (2.1 mmol/L vs 2.2 mmol/L) levels were similar across the educational subgroups, whereas individuals with a low educational level had more pre-existing cardiovascular disease (CVD) (23% vs 17%, PR 1.30 [95% CI 1.16-1.46]). Among people with established CVD, individuals with a low educational level had similar or higher use of prophylactic pharmacological treatment compared to those with a high educational level: statins (90% vs 88%, PR 1.03 [95% CI 0.98-1.07]), angiotensin converting enzyme inhibitors or angiotensin receptor blockers (75% vs 76%, PR 1.00 [95% CI 0.93-1.08]), SGLT2-i (6.5% vs 5.9%, PR 1.06 [95% CI 0.63-1.78]), and GLP1-RA (9.2% vs 6.5%, PR 1.30 [95% CI 0.81-2.06]).

Conclusions: A low educational level was associated with a less healthy lifestyle, obesity, and more CVD in early T2D compared to high educational level, but with similar use of prophylactic pharmacological treatment.