Objective To examine the prevalence, awareness, treatment and control rate of diabetes and their relationship with socioeconomic status (SES) among middle-aged and elderly community residents in Yangzhong city of Jiangsu province and to provide references for promoting diabetes prevention and control.
Methods Using stratified multistage random cluster sampling, we recruited 2 644 residents aged 40 years and above at 6 communities/towns in Yangzhong municipality of Jiangsu province. Questionnaire interview, physical examination and laboratory detection were conducted among the residents from September 2018 to March 2019. Multivariate logistic regression analysis were used to analyze correlations of SES with the prevalence, awareness, treatment and control rate of diabetes. The concentration index (CI) of the prevalence, awareness, treatment and control rate of diabetes were calculated to evaluate health equity.
Results Among the 2 591 residents completing the survey, 275 (10.6%) were diagnosed with diabetes. Of the 275 diabetic participants, 148 (53.8%) were aware of the disease; 116 (42.2%) were under treatment for the disease; and 34 (12.4%) had their blood glucose under control. After adjusting for confounding factors such as gender, age, marital status, residence, smoking, alcohol consumption, physical exercise, and body mass index (BMI), multivariate logistic regression analysis revealed following associations of SES with diabetes-related indicators among the participants: (1) higher education was correlated with decreased diabetes prevalence (junior high school and above vs. illiterate/semiliterate: odds ratio OR = 0.486, 95% confidence interval 95% CI: 0.304 – 0.778); (2) retirement was related to increased rate of awareness on diabetes (retiring vs. being on a job: OR = 5.026, 95% CI: 1.360 – 18.568) and increased rate of diabetes treatment (OR = 2.944, 95% CI = 1.043 – 8.311); (3) middle and high average annual personal income were associated with increased blood glucose control rate (middle vs. the lowest: OR = 6.354, 95% CI: 1.228 – 32.883; high vs. the lowest: OR = 8.404, 95% CI: 1.616 – 43.700). The education- and occupation-related CI values were – 0.029 5 and – 0.017 4 for diabetes prevalence, – 0.009 3 and – 0.014 1 for awareness on diabetes, – 0.008 6 and – 0.011 0 for diabetes treatment, and – 0.013 8 and – 0.027 5 for blood glucose control, respectively; the per capita annual income-related CI for diabetes prevalence and awareness were – 0.002 6 and – 0.001 4, but for diabetes treatment and blood glucose control were 0.020 7 and 0.077 1.
Conclusion The prevalence of diabetes is at a general level but diabetes awareness, treatment and blood glucose control are at a low level among the middle-aged and elderly residents in Yangzhong city; the residents′ diabetes-related indicators are correlated with their socioeconomic status and there is diabetes-related health inequity due to different socioeconomic status.
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