dc.contributor.author |
Wijayaratna, Sasini |
|
dc.contributor.author |
Lee, Arier |
|
dc.contributor.author |
Park, Hyun Young |
|
dc.contributor.author |
Jo, Emmanuel |
|
dc.contributor.author |
Wu, Fiona |
|
dc.contributor.author |
Bagg, Warwick |
|
dc.contributor.author |
Cundy, Tim |
|
dc.coverage.spatial |
England |
|
dc.date.accessioned |
2022-07-12T04:22:36Z |
|
dc.date.available |
2022-07-12T04:22:36Z |
|
dc.date.issued |
2021-12 |
|
dc.identifier.citation |
(2021). BMJ Open Diabetes Research and Care, 9(2), e002485-. |
|
dc.identifier.issn |
2052-4897 |
|
dc.identifier.uri |
https://hdl.handle.net/2292/60365 |
|
dc.description.abstract |
Introduction: Young people with type 2 diabetes (T2D) develop complications earlier than those with type 1 diabetes (T1D) of comparable duration, but it is unclear why. This apparent difference in phenotype could relate to relative inequality. Research design and methods: Cross-sectional study of young people referred to secondary diabetes services in Auckland, Aotearoa-New Zealand (NZ): 731 with T1D and 1350 with T2D currently aged <u><</u>40 years, and diagnosed between 15 and 30 years. Outcome measures were risk factors for complications (glycemic control, urine albumin/creatinine ratio (ACR), cardiovascular disease (CVD) risk) in relation to a validated national index of deprivation (New Zealand Deprivation Index (NZDep)). Results: Young people with T2D were an average 3 years older than those with T1D but had a similar duration of diabetes. 71% of those with T2D were of Māori or Pasifika descent, compared with 24% with T1D (p<0.001). T1D cases were distributed evenly across NZDep categories. 78% of T2D cases were living in the lowest four NZDep categories (p<0.001). In both diabetes types, body mass index (BMI) increased progressively across the NZDep spectrum (p<0.002), as did mean glycated hemoglobin (HbA<sub>1c</sub>) (p<0.001), the prevalence of macroalbuminuria (p≤0.01), and CVD risk (p<0.001). Adjusting for BMI, diabetes type, and duration and age, multiple logistic regression revealed deprivation was the strongest risk factor for poorly controlled diabetes (defined as HbA<sub>1c</sub> >64 mmol/mol, >8%); OR 1.17, 95% CI 1.13 to 1.22, p<0.0001. Ordinal logistic regression showed each decile increase in NZDep increased the odds of a higher ACR by 11% (OR 1.11, 95% CI 1.06 to 1.16, p<0.001) following adjustment for BMI, blood pressure, diabetes type and duration, HbA<sub>1c</sub>, and smoking status. Multiple linear regression indicated a 4% increase in CVD risk for every decile increase in NZDep, regardless of diabetes type. Conclusions: The apparent more aggressive phenotype of young-onset T2D is at least in part explicable by relative deprivation. |
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dc.format.medium |
Print |
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dc.language |
eng |
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dc.publisher |
BMJ |
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dc.relation.ispartofseries |
BMJ open diabetes research & care |
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dc.rights |
Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. |
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dc.rights.uri |
https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm |
|
dc.rights.uri |
https://creativecommons.org/licenses/by-nc/4.0/ |
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dc.subject |
Humans |
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dc.subject |
Diabetes Mellitus, Type 2 |
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dc.subject |
Risk Factors |
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dc.subject |
Cross-Sectional Studies |
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dc.subject |
Social Class |
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dc.subject |
Adolescent |
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dc.subject |
Adult |
|
dc.subject |
Young Adult |
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dc.subject |
Glycated Hemoglobin A |
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dc.subject |
diabetes mellitus |
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dc.subject |
poverty |
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dc.subject |
type 2 |
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dc.subject |
Cardiovascular |
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dc.subject |
Nutrition |
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dc.subject |
Aging |
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dc.subject |
Diabetes |
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dc.subject |
Prevention |
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dc.subject |
Metabolic and endocrine |
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dc.subject |
Science & Technology |
|
dc.subject |
Life Sciences & Biomedicine |
|
dc.subject |
Endocrinology & Metabolism |
|
dc.subject |
GLYCEMIC CONTROL |
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dc.subject |
ONSET |
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dc.subject |
YOUTH |
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dc.subject |
ADOLESCENTS |
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dc.subject |
PREVALENCE |
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dc.subject |
CHILDHOOD |
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dc.subject |
MORTALITY |
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dc.subject |
HEALTH |
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dc.subject |
DEPRIVATION |
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dc.subject |
ADULTS |
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dc.subject |
1103 Clinical Sciences |
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dc.title |
Socioeconomic status and risk factors for complications in young people with type 1 or type 2 diabetes: a cross-sectional study. |
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dc.type |
Journal Article |
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dc.identifier.doi |
10.1136/bmjdrc-2021-002485 |
|
pubs.issue |
2 |
|
pubs.begin-page |
e002485 |
|
pubs.volume |
9 |
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dc.date.updated |
2022-06-15T22:24:49Z |
|
dc.rights.holder |
Copyright: The author |
en |
dc.identifier.pmid |
34969690 (pubmed) |
|
pubs.author-url |
https://www.ncbi.nlm.nih.gov/pubmed/34969690 |
|
pubs.publication-status |
Published |
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dc.rights.accessrights |
http://purl.org/eprint/accessRights/OpenAccess |
en |
pubs.subtype |
Research Support, Non-U.S. Gov't |
|
pubs.subtype |
research-article |
|
pubs.subtype |
Journal Article |
|
pubs.elements-id |
878933 |
|
pubs.org-id |
Medical and Health Sciences |
|
pubs.org-id |
Population Health |
|
pubs.org-id |
Epidemiology & Biostatistics |
|
pubs.org-id |
School of Medicine |
|
pubs.org-id |
Medicine Department |
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dc.identifier.eissn |
2052-4897 |
|
dc.identifier.pii |
9/2/e002485 |
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pubs.number |
ARTN e002485 |
|
pubs.record-created-at-source-date |
2022-06-16 |
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pubs.online-publication-date |
2021-12 |
|