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Income level may affect diabetes risk

By Patricia Nicholson

The risk of developing diabetes may be significantly greater in lower income groups compared to higher income groups, a new study from Women’s College Research Institute (WCRI) and the Institute for Clinical Evaluative Sciences (ICES) shows.

Rates of diabetes have grown rapidly in the past decade, and prevalence has been shown to be higher in lower-income populations. Now, researchers have looked at new cases of diabetes diagnosed in Ontario over a one-year period from April 2006 to March 2007.

“We looked at it within a Canadian population where our health-care system is supposed to equalize differences in health for income. We know that’s not the case, though,” says study author Dr. Lorraine Lipscombe, a scientist with WCRI. “And we also looked at whether differences varied based on age and gender.”

There were 88,886 new cases of diabetes in people ages 20 and older during the study period. The researchers analyzed the results in groups based on income.

“We found that the risk of diabetes was greater for lower income populations compared to higher ones, and we also found that this gap was most marked in younger populations and in women,” Dr. Lipscombe says.

Diabetes risk increased with age, and men had higher rates of diabetes diagnosis than women. However, the effect of income on diabetes diagnosis appeared to be most pronounced in younger age groups (under age 40) and in women. Lower income young people had 1.5 times the diabetes risk of wealthier people in the same age group, but the income-related increase in diabetes narrowed in people over 60. When the researchers looked at women and men separately, the pattern differed: income was linked to a wider gap in relative diabetes risk in women throughout all age groups, while the gap narrowed with age in men.

“It highlights the fact that low income groups are experiencing the greater burden of diabetes,” Dr. Lipscombe says. Although diabetes is on the rise in all groups, lower income populations are at relatively greater risk, and once they get diabetes, they tend to experience worse outcomes. “This is important for resource allocation; it’s important for us to understand preventive measures.”

There are several factors that may put people with low incomes at greater risk for diabetes than higher-income people, Dr. Lipscombe explains.

“They are more likely to be obese, they’re more likely to have less access to healthy food and opportunity for physical activity, and this may be more marked in younger people whereas the effect of aging on diabetes may offset the effect of income in older populations,” she says. “Further research has to be done to figure out why it is.”

The study was published in the journal Diabetes Research and Clinical Practice in March, 2013.

This information is provided by Women’s College Hospital and is not intended to replace the medical advice of your doctor or healthcare provider. Please consult your healthcare provider for advice about a specific medical condition. This document was last reviewed: February, 2014

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