Universität zu Köln

Moenkemoeller, Kirsten ORCID: 0000-0002-9409-441X, Mueller-Godeffroy, Esther, Lilienthal, Eggert, Heidtmann, Bettina, Becker, Marianne, Feldhahn, Lutz, Freff, Markus, Hilgard, Doerte, Krone, Beate, Papsch, Matthias, Schumacher, Andrea, Schwab, Karl O., Schweiger, Heidemarie, Wolf, Johannes, Bollow, Esther and Holl, Reinhard W. (2019). The association between socio-economic status and diabetes care and outcome in children with diabetes type 1 in Germany: The DIAS study (diabetes and social disparities). Pediatr. Diabetes, 20 (5). S. 637 - 645. HOBOKEN: WILEY. ISSN 1399-5448

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Abstract

Objective To evaluate the association between socioeconomic status (SES) and diabetes outcomes in German children and adolescents. Methods A total of 1829 subjects <18 years old with type 1 diabetes mellitus from 13 German diabetes centers were included from June 2013 until June 2014. Data were collected within the multicenter DPV (Diabetes Prospective Follow-up) registry. SES was measured with a composite index. Multivariable regression models were applied to analyze the association of SES and outcomes adjusted for age, sex, diabetes duration, and migration status. Results Low SES was significantly associated with worse diabetes outcomes: higher hemoglobin A1C (HbA1c) (64.3 mmol/mol), lower proportion of insulin pump therapy (43.6%), fewer daily self-monitored blood glucose (SMBG) measurements (5.7), more inpatient days per patient-year (5.8) compared to patients with medium/high SES (HbA1c: 61.3 mmol/mol, P < 0.001/59.8 mmol/mol, P < 0.0001; proportion of pump therapy: 54.5%, P < 0.01/ 54.9%, P < 0.01; SMBG: 6.0, P < 0.01/ 6.1, P < 0.01; inpatient days: 4.5, P < 0.0001/3.4, P < 0.0001). The inclusion of migration status in the models resulted in only minor changes in the outcomes. Conclusion Despite free health care, low SES is associated with unfavorable diabetes outcomes in Germany. The poorer diabetes outcomes of children with diabetes have been attributed to their migration status and may be partly explained by low SES. Both factors must become part of targeted diabetes care in children and adolescents with type 1 diabetes.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Moenkemoeller, Kirsten UNSPECIFIED orcid.org/0000-0002-9409-441X UNSPECIFIED Mueller-Godeffroy, Esther UNSPECIFIED UNSPECIFIED UNSPECIFIED Lilienthal, Eggert UNSPECIFIED UNSPECIFIED UNSPECIFIED Heidtmann, Bettina UNSPECIFIED UNSPECIFIED UNSPECIFIED Becker, Marianne UNSPECIFIED UNSPECIFIED UNSPECIFIED Feldhahn, Lutz UNSPECIFIED UNSPECIFIED UNSPECIFIED Freff, Markus UNSPECIFIED UNSPECIFIED UNSPECIFIED Hilgard, Doerte UNSPECIFIED UNSPECIFIED UNSPECIFIED Krone, Beate UNSPECIFIED UNSPECIFIED UNSPECIFIED Papsch, Matthias UNSPECIFIED UNSPECIFIED UNSPECIFIED Schumacher, Andrea UNSPECIFIED UNSPECIFIED UNSPECIFIED Schwab, Karl O. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schweiger, Heidemarie UNSPECIFIED UNSPECIFIED UNSPECIFIED Wolf, Johannes UNSPECIFIED UNSPECIFIED UNSPECIFIED Bollow, Esther UNSPECIFIED UNSPECIFIED UNSPECIFIED Holl, Reinhard W. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-134159
DOI:	10.1111/pedi.12847
Journal or Publication Title:	Pediatr. Diabetes
Volume:	20
Number:	5
Page Range:	S. 637 - 645
Date:	2019
Publisher:	WILEY
Place of Publication:	HOBOKEN
ISSN:	1399-5448
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language GLYCEMIC CONTROL; RISK-FACTORS; HEALTH DISPARITIES; ETHNIC DISPARITIES; YOUNG-ADULTS; ADOLESCENTS; COMPLICATIONS; DETERMINANTS; INCOME; YOUTH Multiple languages Endocrinology & Metabolism; Pediatrics Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/13415