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Diabetic Medicine

Year: 2012  |  Volume: 29  |  Issue: 5  |  Page No.: 640 - 645

Differences in the quality of diabetes care caused by social inequalities disappear after treatment and education in a tertiary care centre

L. Baz, N. Muller, E. Beluchin, C. Kloos, T. Lehmann, G. Wolf and U. A. Muller

Abstract

Aim  To assess the relationship between social status and quality of diabetes care in a tertiary care centre in Germany.

Methods  Social status was assessed in 940 consecutive patients in a university outpatient department by a questionnaire. The assessment comprised three components: education, highest professional position and household net income (total score 3-21). Quality of diabetes care was measured by HbA1c, blood pressure and BMI. The influence of social status on quality measures was analysed at entry and last visit by fitting linear mixed models.

Results  At the entry visit, patients with lower social status had a higher HbA1c compared with patients with higher status (0.06% per each point of social score difference). After a mean follow- up of 6.0 years (Type 2 diabetes) and 9.4 years (Type 1 diabetes) no significant differences in HbA1c could be found. However, difference in BMI (−0.41 kg/m2 per each point of social score) persisted at last observation. Blood pressure was only negligibly affected by the care programme.

Conclusions  Low social status is associated with worse quality of diabetes care at entry in a tertiary care centre. The differences in HbA1c disappeared after treatment and structured education, whereas the difference in BMI persisted. There was no significant influence of social status or treatment on blood pressure.

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