Universität zu Köln

Mueller-Godeffroy, Esther, Moenkemoeller, Kirsten, Lilienthal, Eggert, Heidtmann, Bettina, Becker, Marianne, Feldhahn, Lutz, Freff, Markus, Hilgard, Doerte, Krone, Beate, Papsch, Matthias, Schumacher, Andrea, Schwab, Karl-Otfried, Schweiger, Heidemarie, Wolf, Johannes, Bollow, Esther and Holl, Reinhard (2021). The association between educational status and diabetes outcomes: results of the DIAS study in children with diabetes type 1 in Germany. Diabetol. Stoffwechs., 16 (3). S. 211 - 219. STUTTGART: GEORG THIEME VERLAG KG. ISSN 1861-9010

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Abstract

Objective To evaluate the association between parents' educational status and diabetes outcomes in German children and adolescents and to compare educational status and individual socioeconomic status (SES). Methods The study included a total of 1781 patients < 18 years old with type 1 diabetes mellitus from 13 German diabetes centers. The analysis was based on data from the DIAS study collected from June 2013 until June 2014 in order to analyse the associations of SES and various diabetes outcomes. The DIAS study measured SES with a composite index based on parents' educational status, occupational status and household income and presented unfavourable outcomes for patients with a low SES. In a secondary analysis of the DIAS data, analyses have been run again with parents' educational status only in order to examine its applicability as a short indicator of SES. Data were collected within the multicenter DPV ( Diabetes Prospective Follow- up) registry. Multivariable regression models ( linear, logistic, negativ-binomial or Poisson- models depending on the distributional characteristics of the outcomes) were applied to analyze the associations of parents' educational status and diabetes outcomes, adjusted for age, sex, diabetes duration, and eventually migration background. Results Low educational status was significantly associated with higher hemoglobin A1C (HbA1c) compared to medium/high educational status (8,1 % compared to 7,8 %, p < 0,0001/ 7,6 %, p < 0,0001), and lower proportion of insulin pump therapy (42,7 % versus 56,3 %, p < 0,0001/52,5 %, p < 0,01). Patients with a background of low educational status also reported fewer daily self- monitored blood glucose (SMBG) measurements, higher Body-Mass-Index, and more inpatient days per year. Severe hypoglycemic events and ketoacidosis were not more frequent in patients with low educational status. The educational status measure was able to discriminate between the social groups as well as the complex SES measure. Conclusion Parents' low educational status is an important predictor for unfavorable outcomes in German children with type-1 diabetes. We should incorporate this aspect in targeted diabetes care and education. As a short and practicable indicator, parents' educational status can estimate the social status of the patients in routine collection of diabetes data.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Mueller-Godeffroy, Esther UNSPECIFIED UNSPECIFIED UNSPECIFIED Moenkemoeller, Kirsten 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-Otfried UNSPECIFIED UNSPECIFIED UNSPECIFIED Schweiger, Heidemarie UNSPECIFIED UNSPECIFIED UNSPECIFIED Wolf, Johannes UNSPECIFIED UNSPECIFIED UNSPECIFIED Bollow, Esther UNSPECIFIED UNSPECIFIED UNSPECIFIED Holl, Reinhard UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-601767
DOI:	10.1055/a-1452-8684
Journal or Publication Title:	Diabetol. Stoffwechs.
Volume:	16
Number:	3
Page Range:	S. 211 - 219
Date:	2021
Publisher:	GEORG THIEME VERLAG KG
Place of Publication:	STUTTGART
ISSN:	1861-9010
Language:	German
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language METABOLIC-CONTROL; GLYCEMIC CONTROL; ADOLESCENTS; METAANALYSIS; FREQUENCY Multiple languages Endocrinology & Metabolism Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/60176