Modifiable Risk Factors Key in Social Inequality of Diabetes

Repeated measures of health behaviors, BMI account for about half of social differential

THURSDAY, Aug. 23 (HealthDay News) -- Modifiable risk factors, particularly health behaviors and body mass index (BMI), measured repeatedly over time, account for about half of the socioeconomic differential observed in type 2 diabetes, according to a study published online Aug. 21 in BMJ.

Silvia Stringhini, Ph.D., of the Lausanne University Hospital in Switzerland, and colleagues conducted a prospective cohort study involving 7,237 adults from the U.K. Civil Service without diabetes, with an average age of 49.4 years, to assess the contribution of modifiable risk factors to social inequalities in type 2 diabetes.

During a mean follow-up of 14.2 years, the researchers identified 818 incident cases of diabetes. Compared with individuals in the highest occupational category, those in the lowest category had a significantly increased risk of developing diabetes (hazard ratio, 1.86). Health behaviors and BMI accounted for 33, 36, and 45 percent, respectively, of this socioeconomic differential when risk factors were assessed at baseline, when they were repeatedly assessed, and when long-term exposure during follow-up was taken into account. A total of 53 percent of the socioeconomic differential was explained with further adjustment for biological risk factors.

"Health behaviors and body mass index explain almost half of the association between socioeconomic status and incidence of type 2 diabetes," the authors write. "Given the increasing burden of type 2 diabetes and the observed increase in social inequalities in prevalence of type 2 diabetes, further efforts to tackle these factors are urgently needed."

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