医学
社会经济地位
队列
人口学
2型糖尿病
民族
队列研究
邻里(数学)
老年学
糖尿病
回顾性队列研究
环境卫生
内科学
人口
数学分析
数学
社会学
人类学
内分泌学
作者
David C Lee,Stephanie L. Orstad,Rania Kanchi,Samrachana Adhikari,Pasquale E. Rummo,Andrea R Titus,José O. Alemán,Brian Elbel,Lorna E. Thorpe,Mark D. Schwartz
出处
期刊:BMJ Open
[BMJ]
日期:2023-10-01
卷期号:13 (10): e075599-e075599
标识
DOI:10.1136/bmjopen-2023-075599
摘要
This study evaluated whether a range of demographic, social and geographic factors had an influence on glycaemic control longitudinally after an initial diagnosis of diabetes.We used the US Veterans Administration Diabetes Risk national cohort to track glycaemic control among patients 20-79-year old with a new diagnosis of type 2 diabetes.We modelled associations between glycaemic control at follow-up clinical assessments and geographic factors including neighbourhood race/ethnicity, socioeconomic, land use and food environment measures. We also adjusted for individual demographics, comorbidities, haemoglobin A1c (HbA1c) at diagnosis and duration of follow-up. These factors were analysed within strata of community type: high-density urban, low-density urban, suburban/small town and rural areas.We analysed 246 079 Veterans who developed a new type 2 diabetes diagnosis in 2008-2018 and had at least 2 years of follow-up data available. Across all community types, we found that lower baseline HbA1c and female sex were strongly associated with a higher likelihood of within-range HbA1c at follow-up. Surprisingly, patients who were older or had more documented comorbidities were more likely to have within-range follow-up HbA1c results. While there was variation by community type, none of the geographic measures analysed consistently demonstrated significant associations with glycaemic control across all community types.
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