Low Socioeconomic Status is Associated with Increased Risk for Hypoglycemia in Diabetes Patients: the Diabetes Study of Northern California (DISTANCE)

Overview

Journal J Health Care Poor Underserved

Publisher Johns Hopkins University Press

Date 2014 May 27

PMID 24858863

Citations 32

Authors

Seth A Berkowitz

Andrew J Karter

Courtney R Lyles

Jennifer Y Liu

Dean Schillinger

Nancy E Adler

Howard H Moffet

Urmimala Sarkar

Affiliations

Soon will be listed here.

Abstract

Background: Social risk factors for hypoglycemia are not well understood.

Methods: Cross-sectional analysis from the DISTANCE study, a multi-language, ethnically-stratified random sample of adults in the Kaiser Permanente Northern California diabetes registry, conducted in 2005-2006 (response rate 62%). Exposures were income and educational attainment; outcome was patient report of severe hypoglycemia. To test the association, we used multivariable logistic regression to adjust for demographic and clinical factors.

Results: 14,357 patients were included. Reports of severe hypoglycemia were common (11%), and higher in low-income vs. high-income (16% vs. 8.8) and low-education vs. high-education (11.9% vs. 8.9%) groups. In multivariable analysis, incomes of less than $15,000 (OR 1.51 95%CI 1.19-1.91), $15,000-$24,999 (OR 1.57 95%CI 1.27-1.94), and high school or less education (OR 1.42, 95% CI 1.24-1.63) were associated with increased hypoglycemia, similar to insulin use (OR 1.44 95%CI 1.19-1.74).

Conclusions: Low income and educational attainment are important risk factors for hypoglycemia.

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