PMID- 32611580
OWN - NLM
STAT- MEDLINE
DCOM- 20210621
LR  - 20210621
IS  - 2052-4897 (Electronic)
IS  - 2052-4897 (Linking)
VI  - 8
IP  - 1
DP  - 2020 Jul
TI  - Effect of socioeconomic deprivation on outcomes of diabetes complications in 
      patients with type 2 diabetes mellitus: a nationwide population-based cohort 
      study of South Korea.
LID - 10.1136/bmjdrc-2019-000729 [doi]
LID - e000729
AB  - INTRODUCTION: This study aimed to examine the effect of socioeconomic deprivation 
      on the outcomes of diabetes complications in patients with type 2 diabetes 
      mellitus (T2DM). RESEARCH DESIGN AND METHODS: We conducted a cohort study using 
      claims data and 2005 national census data. We included of 7510 patients newly 
      diagnosed with T2DM from 2004 to 2012 and aged 40 years or above. We excluded 
      participants who had onset of diabetes complications and hospitalization within 
      1 year after initial onset T2DM, aged less than 40 years and with missing 
      covariates. We used the regional socioeconomic deprivation index and classified 
      study participants into five categories according to the quintile distribution. 
      We calculated the adjusted HR and 95% CI for hospitalization related to diabetes 
      complications and all-cause mortality by applying Cox proportional hazards model 
      and the adjusted subdistribution hazards model. RESULTS: The percentages of 
      participants in the first quintile (least deprived) to fifth quintile (most 
      deprived) were 27.0%, 27.9%, 19.5%, 14.8%, and 10.8% for socioeconomic 
      deprivation; 25.4%, 28.8%, 32.4%, 34.6%, and 37.6% for hospitalization due to 
      diabetes complications; 1.3%, 2.1%, 2.5%, 2.9%, and 3.6% for deaths from diabetes 
      complications; and 5.7%, 7.2%, 9.7%, 9.7%, and 13.1% for deaths from all causes, 
      respectively. Participants with higher socioeconomic deprivation had a higher HR 
      for hospitalization and mortality from all-cause and diabetes complications. 
      These associations were the strongest among men and participants in their 40s in 
      hospitalization related to diabetes complications, 50s in diabetes 
      complications-specific mortality and 50s and 60s in all-cause mortality. 
      CONCLUSIONS: Patients with T2DM with high socioeconomic deprivation had higher 
      hospital admission and mortality rates for diabetes complications than those with 
      low deprivation. We cannot fully explain the effect of socioeconomic deprivation 
      on diabetes outcomes. Therefore, further studies are needed in order to find 
      underlying mechanisms for these associations.
CI  - (c) Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No 
      commercial re-use. See rights and permissions. Published by BMJ.
FAU - Choi, Dong-Woo
AU  - Choi DW
AUID- ORCID: 0000-0001-5462-7579
AD  - Department of Public Health, Graduate School, Yonsei University, Seoul, Korea 
      (the Republic of).
FAU - Lee, Sang Ah
AU  - Lee SA
AD  - Research and Analysis Team, National Health Insurance Corporation Ilsan Hospital, 
      Goyang, Gyeonggi-do, Korea (the Republic of).
FAU - Lee, Doo Woong
AU  - Lee DW
AD  - Department of Public Health, Graduate School, Yonsei University, Seoul, Korea 
      (the Republic of).
FAU - Joo, Jae Hong
AU  - Joo JH
AD  - Department of Public Health, Graduate School, Yonsei University, Seoul, Korea 
      (the Republic of).
FAU - Han, Kyu-Tae
AU  - Han KT
AUID- ORCID: 0000-0002-5817-1203
AD  - Division of Cancer Management Policy, National Cancer Center, Goyang, 
      Gyeonggi-do, Korea (the Republic of).
FAU - Kim, SeungJu
AU  - Kim S
AUID- ORCID: 0000-0003-3308-3802
AD  - Department of Nursing, Eulji University, Seongnam, Gyeonggi-do, Korea (the 
      Republic of).
FAU - Park, Eun-Cheol
AU  - Park EC
AD  - Department Preventive Medicine, Yonsei University College of Medicine, 
      Seodaemun-gu, Seoul, Korea (the Republic of) ecpark@yuhs.ac.
LA  - eng
PT  - Journal Article
PL  - England
TA  - BMJ Open Diabetes Res Care
JT  - BMJ open diabetes research & care
JID - 101641391
SB  - IM
MH  - Cohort Studies
MH  - *Diabetes Complications
MH  - *Diabetes Mellitus, Type 2/complications/epidemiology
MH  - Humans
MH  - Male
MH  - Republic of Korea/epidemiology
MH  - Socioeconomic Factors
PMC - PMC7332202
OTO - NOTNLM
OT  - complication(s)
OT  - mortality
OT  - socioeconomic deprivation
OT  - type 2 diabetes
COIS- Competing interests: None declared.
EDAT- 2020/07/03 06:00
MHDA- 2021/06/22 06:00
PMCR- 2020/07/01
CRDT- 2020/07/03 06:00
PHST- 2019/07/02 00:00 [received]
PHST- 2020/05/04 00:00 [revised]
PHST- 2020/05/26 00:00 [accepted]
PHST- 2020/07/03 06:00 [entrez]
PHST- 2020/07/03 06:00 [pubmed]
PHST- 2021/06/22 06:00 [medline]
PHST- 2020/07/01 00:00 [pmc-release]
AID - 8/1/e000729 [pii]
AID - bmjdrc-2019-000729 [pii]
AID - 10.1136/bmjdrc-2019-000729 [doi]
PST - ppublish
SO  - BMJ Open Diabetes Res Care. 2020 Jul;8(1):e000729. doi: 
      10.1136/bmjdrc-2019-000729.