Socioeconomic position and cardiovascular risk factors among people with screen-detected Type 2 DM: Six-year follow-up of the ADDITION-Denmark trial

Else Marie Dalsgaard; Mogens Vestergaard; Mette Vinther Skriver; Knut Borch-Johnsen; Torsten Lauritzen; Annelli Sandbaek

doi:10.1016/j.pcd.2014.01.006

Socioeconomic position and cardiovascular risk factors among people with screen-detected Type 2 DM: Six-year follow-up of the ADDITION-Denmark trial

Else Marie Dalsgaard^*
, Mogens Vestergaard
, Mette Vinther Skriver
, Knut Borch-Johnsen
, Torsten Lauritzen
, Annelli Sandbaek

^*Corresponding author for this work

Management (HOL)

Research output: Contribution to journal › Article › Research › peer-review

Abstract

Aims To examine whether socioeconomic position (SEP) was associated with change in cardiovascular risk factors and meeting treatment targets for cardiovascular risk factors among individuals with screen-detected Type 2 DM at six-year follow-up.

Methods The study population was 1533 people with Type 2 DM identified from at stepwise diabetes screening programme in general practice during 2001-2006 in the ADDITION-Denmark study. The ADDITION-study was performed as a randomised trial but the two randomisation groups were analysed as one cohort in this study. Cardiovascular risk factors were measured at baseline and repeated at follow-up (mean: 5.9 [1.4] years). Information on SEP, redeemed antihypertensive and lipid-lowering treatment were obtained from Danish registers. Multivariate analyses were performed to estimate change in cardiovascular risk factors and difference in meeting treatment targets.

Results The change in HbA_1c, cholesterol, blood pressure and BMI were virtually the same across educational level, income level, occupational status or cohabiting status. Overall, the ability to meet treatment targets for HbA_1c, cholesterol and blood pressure was not modified by SEP-group. A higher proportion of people with lower educational level or lower income level in the intensive care redeemed anti-hypertensive treatment compared to people with higher educational or income levels.

Conclusion Screen-detection and early treatment onset did not introduce socioeconomic inequality in metabolic control in people with screen-detected Type 2 DM at six-year follow-up.

Original language	English
Pages (from-to)	322-329
Number of pages	8
Journal	Primary Care Diabetes
Volume	8
Issue number	4
DOIs	https://doi.org/10.1016/j.pcd.2014.01.006
Publication status	Published - 1 Dec 2014

Funding

ADDITION-Denmark was supported by the National Health Services in the counties of Copenhagen, Aarhus, Ringkøbing, Ribe and South Jutland in Denmark, The Danish Council for Strategic Research, the Danish Founding for General Practice, Novo Nordisk Foundation, the Danish center for Evaluation and Health Technology Assessment, the Danish Fund of the National Board of Health, the Danish Medical Research Council, and the Aarhus University Research foundation. The trail has been given unrestricted grants from Novo Nordisk AS, Novo Nordisk Scandinavia AB, Novo Nordisk UK, ASTRA Denmark, Pfizer Denmark, Glaxo SmidthKline Pharma Denmark, Servier Denmark A/S and HemoCue Denmark A/S. Parts of the grants from Novo Nordisk Foundation and Novo Nordisk were transferred to the other centers.

Keywords

Cardiovascular risk factors
General practice
Socioeconomic position
Type 2 diabetes mellitus

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10.1016/j.pcd.2014.01.006

Cite this

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title = "Socioeconomic position and cardiovascular risk factors among people with screen-detected Type 2 DM: Six-year follow-up of the ADDITION-Denmark trial",

abstract = "Aims To examine whether socioeconomic position (SEP) was associated with change in cardiovascular risk factors and meeting treatment targets for cardiovascular risk factors among individuals with screen-detected Type 2 DM at six-year follow-up.Methods The study population was 1533 people with Type 2 DM identified from at stepwise diabetes screening programme in general practice during 2001-2006 in the ADDITION-Denmark study. The ADDITION-study was performed as a randomised trial but the two randomisation groups were analysed as one cohort in this study. Cardiovascular risk factors were measured at baseline and repeated at follow-up (mean: 5.9 [1.4] years). Information on SEP, redeemed antihypertensive and lipid-lowering treatment were obtained from Danish registers. Multivariate analyses were performed to estimate change in cardiovascular risk factors and difference in meeting treatment targets.Results The change in HbA1c, cholesterol, blood pressure and BMI were virtually the same across educational level, income level, occupational status or cohabiting status. Overall, the ability to meet treatment targets for HbA1c, cholesterol and blood pressure was not modified by SEP-group. A higher proportion of people with lower educational level or lower income level in the intensive care redeemed anti-hypertensive treatment compared to people with higher educational or income levels.Conclusion Screen-detection and early treatment onset did not introduce socioeconomic inequality in metabolic control in people with screen-detected Type 2 DM at six-year follow-up.",

keywords = "Cardiovascular risk factors, General practice, Socioeconomic position, Type 2 diabetes mellitus",

author = "Dalsgaard, \{Else Marie\} and Mogens Vestergaard and Skriver, \{Mette Vinther\} and Knut Borch-Johnsen and Torsten Lauritzen and Annelli Sandbaek",

year = "2014",

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doi = "10.1016/j.pcd.2014.01.006",

language = "English",

volume = "8",

pages = "322--329",

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Socioeconomic position and cardiovascular risk factors among people with screen-detected Type 2 DM: Six-year follow-up of the ADDITION-Denmark trial. / Dalsgaard, Else Marie; Vestergaard, Mogens; Skriver, Mette Vinther et al.
In: Primary Care Diabetes, Vol. 8, No. 4, 01.12.2014, p. 322-329.

Research output: Contribution to journal › Article › Research › peer-review

TY - JOUR

T1 - Socioeconomic position and cardiovascular risk factors among people with screen-detected Type 2 DM

T2 - Six-year follow-up of the ADDITION-Denmark trial

AU - Dalsgaard, Else Marie

AU - Vestergaard, Mogens

AU - Skriver, Mette Vinther

AU - Borch-Johnsen, Knut

AU - Lauritzen, Torsten

AU - Sandbaek, Annelli

PY - 2014/12/1

Y1 - 2014/12/1

N2 - Aims To examine whether socioeconomic position (SEP) was associated with change in cardiovascular risk factors and meeting treatment targets for cardiovascular risk factors among individuals with screen-detected Type 2 DM at six-year follow-up.Methods The study population was 1533 people with Type 2 DM identified from at stepwise diabetes screening programme in general practice during 2001-2006 in the ADDITION-Denmark study. The ADDITION-study was performed as a randomised trial but the two randomisation groups were analysed as one cohort in this study. Cardiovascular risk factors were measured at baseline and repeated at follow-up (mean: 5.9 [1.4] years). Information on SEP, redeemed antihypertensive and lipid-lowering treatment were obtained from Danish registers. Multivariate analyses were performed to estimate change in cardiovascular risk factors and difference in meeting treatment targets.Results The change in HbA1c, cholesterol, blood pressure and BMI were virtually the same across educational level, income level, occupational status or cohabiting status. Overall, the ability to meet treatment targets for HbA1c, cholesterol and blood pressure was not modified by SEP-group. A higher proportion of people with lower educational level or lower income level in the intensive care redeemed anti-hypertensive treatment compared to people with higher educational or income levels.Conclusion Screen-detection and early treatment onset did not introduce socioeconomic inequality in metabolic control in people with screen-detected Type 2 DM at six-year follow-up.

AB - Aims To examine whether socioeconomic position (SEP) was associated with change in cardiovascular risk factors and meeting treatment targets for cardiovascular risk factors among individuals with screen-detected Type 2 DM at six-year follow-up.Methods The study population was 1533 people with Type 2 DM identified from at stepwise diabetes screening programme in general practice during 2001-2006 in the ADDITION-Denmark study. The ADDITION-study was performed as a randomised trial but the two randomisation groups were analysed as one cohort in this study. Cardiovascular risk factors were measured at baseline and repeated at follow-up (mean: 5.9 [1.4] years). Information on SEP, redeemed antihypertensive and lipid-lowering treatment were obtained from Danish registers. Multivariate analyses were performed to estimate change in cardiovascular risk factors and difference in meeting treatment targets.Results The change in HbA1c, cholesterol, blood pressure and BMI were virtually the same across educational level, income level, occupational status or cohabiting status. Overall, the ability to meet treatment targets for HbA1c, cholesterol and blood pressure was not modified by SEP-group. A higher proportion of people with lower educational level or lower income level in the intensive care redeemed anti-hypertensive treatment compared to people with higher educational or income levels.Conclusion Screen-detection and early treatment onset did not introduce socioeconomic inequality in metabolic control in people with screen-detected Type 2 DM at six-year follow-up.

KW - Cardiovascular risk factors

KW - General practice

KW - Socioeconomic position

KW - Type 2 diabetes mellitus

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DO - 10.1016/j.pcd.2014.01.006

M3 - Article

C2 - 24613817

AN - SCOPUS:84916597178

SN - 1751-9918

VL - 8

SP - 322

EP - 329

JO - Primary Care Diabetes

JF - Primary Care Diabetes

IS - 4

ER -

Socioeconomic position and cardiovascular risk factors among people with screen-detected Type 2 DM: Six-year follow-up of the ADDITION-Denmark trial

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