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 relationship of socioeconomic status on five risk factors: obesity, hypertension, high cholesterol. smoking, and high HbA(1c). RESEARCH DESIGN AND METHODS - We conducted a cross-sectional prevalence study of all patients with diabetes (n = 1,553) attending a clinic in Glasgow, U.K. Area-based codes were used to measure socioeconomic status; these ranged from 1, the most affluent, to 7, the most deprived. RESULTS - Comparing patients with NIDDM from the seven categories of socioeconomic status, we found that those from deprived categories experienced a higher prevalence 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). With regard to smoking, 13% in the most affluent category smoked compared with 33% in the most deprived (P < 0.001). In patients with IDDM from affluent categories, 13% smoked compared with 34% from the deprived categories (P < 0.001). The proportion of patients with no cardiac risk 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 :rom 8.6% in category 1 to 20.2% in category 7. CONCLUSIONS - Diabetic patients from areas of low socioeconomic status are at increased risk of cardiovascular disease. To counter this, specific health education programs should be evolved and resources should be directed toward these areas.