Mortality rates higher among people with diabetes whose socioeconomic status is low

Low income and educational level almost triples the risk that people with type 1 diabetes will die of cerebral infarction. A doctoral thesis at Sahlgrenska Academy also showed the conclusion that type diabetes 1 is declining among young people to be unfounded.

Approximately 400,000 Swedes have diabetes, and type 1 diabetes is the second most common chronic disease among children and young adults.

Newer studies have suggested that 15-34 year-olds are developing type 1 diabetes at a slower rate than previously. A recent doctoral thesis at Sahlgrenska Academy, University of Gothenburg, determined that the conclusion is erroneous—incidence is two to three times as great as had been estimated.

In collaboration with the National Diabetes Register, Araz Rawshani also explored the impact of socioeconomic status and ethnicity on the progress of diabetes.

His findings demonstrated that:

  • People with type 1 diabetes whose income and educational levels are low face almost three times as great a risk of developing cerebral infraction, stroke and death as those whose income and educational levels are high.
  • Earning a low income raises the risk of developing heart failure by 70% among people with diabetes compared with those whose income is high.

“Such gaps cannot be explained by either traditional risk factors or other demographic variables,” says Dr. Rawshani. “Considering that socioeconomic factors may pose a greater danger than the factors previously identified, the kinds of medical checkups currently performed fail to identify all high-risk patients.”

  • Swedes born in non-European countries develop type 2 diabetes an average of ten years earlier in life than native Swedes. Swedes born in non-European countries with diabetes are also more likely to fall short of treatment goals and develop kidney damage even though they obtain earlier treatment and have more frequent appointments with caregivers.
  • The risk of developing heart failure has an ethnic component. Swedes born in South Asia face a greater risk than native Swedes, whereas those born in Latin America face a lower risk.

The Gothenburg studies concluded that the healthcare system needs to pay more heed to ethnicity and socioeconomic status, devote greater resources to individualized care and rewrite the national diabetes guidelines.

“Research evidence concerning socioeconomic and ethnic differences must be disseminated, and the national guidelines should delineate this challenge more clearly,” says Soffia Gudbjörnsdottir at the National Diabetes Register.

The researchers are planning additional studies to identify ways of the breaking and preventing the vicious cycle of low socioeconomic status and diabetes.

Dr. Rawshani defended Socioeconomic Aspects of Diabetes and Cardiovascular Disease on June 1.

Link to thesis:

For additional information, feel free to contact:
Araz Rawshani, Sahlgrenska Academy, University of Gothenburg
Cell: +46 8-768 762685

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The Sahlgrenska Academy is the faculty of health sciences at the University of Gothenburg. Education and research are conducted within the fields of pharmacy, medicine, odontology and health care sciences. About 4,000 undergraduate students and 1,200 postgraduate students are enrolled at Sahlgrenska Academy. Around 1,400 people work at the Sahlgrenska Academy, 850 of them are researchers and/or teachers. 2013 Sahlgrenska Academy had a turnover of 2,4 billion SEK.






Socioeconomic factors may pose a greater danger than traditional risk factors.
Araz Rawshani, researcher at the Sahlgrenska Academy