Large socioeconomic gap in period life expectancy and life years spent with complications of diabetes in the Scottish population with type 1 diabetes, 2013–2018

Höhn, A. et al. (2022) Large socioeconomic gap in period life expectancy and life years spent with complications of diabetes in the Scottish population with type 1 diabetes, 2013–2018. PLoS ONE, 17(8), e0271110. (doi: 10.1371/journal.pone.0271110) (PMID:35951518)

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Abstract

Background: We report the first study to estimate the socioeconomic gap in period life expectancy (LE) and life years spent with and without complications in a national cohort of individuals with type 1 diabetes. Methods: This retrospective cohort study used linked healthcare records from SCI-Diabetes, the population-based diabetes register of Scotland. We studied all individuals aged 50 and older with a diagnosis of type 1 diabetes who were alive and residing in Scotland on 1 January 2013 (N = 8591). We used the Scottish Index of Multiple Deprivation (SIMD) 2016 as an area-based measure of socioeconomic deprivation. For each individual, we constructed a history of transitions by capturing whether individuals developed retinopathy/maculopathy, cardiovascular disease, chronic kidney disease, and diabetic foot, or died throughout the study period, which lasted until 31 December 2018. Using parametric multistate survival models, we estimated total and state-specific LE at an attained age of 50. Results: At age 50, remaining LE was 22.2 years (95% confidence interval (95% CI): 21.6 − 22.8) for males and 25.1 years (95% CI: 24.4 − 25.9) for females. Remaining LE at age 50 was around 8 years lower among the most deprived SIMD quintile when compared with the least deprived SIMD quintile: 18.7 years (95% CI: 17.5 − 19.9) vs. 26.3 years (95% CI: 24.5 − 28.1) among males, and 21.2 years (95% CI: 19.7 − 22.7) vs. 29.3 years (95% CI: 27.5 − 31.1) among females. The gap in life years spent without complications was around 5 years between the most and the least deprived SIMD quintile: 4.9 years (95% CI: 3.6 − 6.1) vs. 9.3 years (95% CI: 7.5 − 11.1) among males, and 5.3 years (95% CI: 3.7 − 6.9) vs. 10.3 years (95% CI: 8.3 − 12.3) among females. SIMD differences in transition rates decreased marginally when controlling for time-updated information on risk factors such as HbA1c, blood pressure, BMI, or smoking. Conclusions: In addition to societal interventions, tailored support to reduce the impact of diabetes is needed for individuals from low socioeconomic backgrounds, including access to innovations in management of diabetes and the prevention of complications.

Item Type:Articles
Additional Information:Funding: This study was supported by funding from Diabetes UK. In particular the following grants: 17/0005627 - received by HMC 8/0005786 - received by TMC.
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Kennon, Dr Brian and Hoehn, Dr Andreas and Sattar, Professor Naveed and Petrie, Professor John and Seaman, Dr Rosie
Authors: Höhn, A., McGurnaghan, S. J., Caparrotta, T. M., Jeyam, A., O'Reilly, J. E., Blackbourn, L. A. K., Hatam, S., Dudel, C., Seaman, R. J., Mellor, J., Sattar, N., McCrimmon, R. J., Kennon, B., Petrie, J. R., Wild, S., McKeigue, P. M., Colhoun, H. M., and on behalf of the SDRN-Epi Group,
College/School:College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > MRC/CSO SPHSU
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:PLoS ONE
Publisher:Public Library of Science
ISSN:1932-6203
ISSN (Online):1932-6203
Copyright Holders:Copyright © 2022 Höhn et al
First Published:First published in PLoS ONE 17(8): e0271110
Publisher Policy:Reproduced under a Creative Commons licence

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