SOCIOECONOMIC-STATUS AND CLUSTERING OF CARDIOVASCULAR-DISEASE RISK-FACTORS IN DIABETIC-PATIENTS

OBJECTIVE - Correction of cardiovascular risk factors is an essential component of good diabetes care. Our goal was to examine the relations hip of socioeconomic status on five risk factors: obesity, hypertensio n, high cholesterol. smoking, and high HbA(1c). RESEARCH DESIGN AND ME THODS - We conducted a cross-sectional prevalence study of all patient s with diabetes (n = 1,553) attending a clinic in Glasgow, U.K. Area-b ased codes were used to measure socioeconomic status; these ranged fro m 1, the most affluent, to 7, the most deprived. RESULTS - Comparing p atients with NIDDM from the seven categories of socioeconomic status, we found that those from deprived categories experienced a higher prev alence of obesity. In the most affluent groups, 30% had a BMI > 30 kg/ m(2) compared with 47% in the most deprived categories (P < 0.002). Wi th regard to smoking, 13% in the most affluent category smoked compare d with 33% in the most deprived (P < 0.001). In patients with IDDM fro m affluent categories, 13% smoked compared with 34% from the deprived categories (P < 0.001). The proportion of patients with no cardiac ris k factors fell by 30.6% from deprivation category 1 to 7 (P < 0.001), and the proportion of patients with three or more risk factors rose :r om 8.6% in category 1 to 20.2% in category 7. CONCLUSIONS - Diabetic p atients from areas of low socioeconomic status are at increased risk o f cardiovascular disease. To counter this, specific health education p rograms should be evolved and resources should be directed toward thes e areas.