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ORIGINAL ARTICLE
Year : 2015  |  Volume : 19  |  Issue : 6  |  Page : 775-780

Association of low educational status with microvascular complications in type 2 diabetes: Jaipur diabetes registry


1 Department of Medicine, Mahatma Gandhi Medical College and Hospital, Jaipur, Rajasthan, India
2 Department of Endocrinology, Galaxy Specialty Centre, Jaipur, Rajasthan, India
3 Department of Medicine, Fortis Escorts Hospital, Jaipur, Rajasthan, India

Correspondence Address:
Surendra Kumar Sharma
Department of Endocrinology, Galaxy Specialty Centre, Ajmer Road, Jaipur - 302 006, Rajasthan
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2230-8210.167552

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Objective: To determine the association of educational status (ES), as marker of socioeconomic status, with the prevalence of microvascular complications in diabetes.Methods: Successive patients (n = 1214) presenting to our center were evaluated for sociodemographic, anthropometric, clinical, and therapeutic variables. Subjects were classified according to ES into Group 1 (illiterate, 216); Group 2 (≤ primary, 537), Group 3 (≤ higher secondary, 312), and Group 4 (any college, 149). Descriptive statistics is reported. Results: Mean age of patients was 52 ± 10 years, duration of diabetes 7 ± 7 years and 55% were men. Prevalence of various risk factors was smoking/tobacco 25.5%, obesity body mass index ≥25 kg/m2 64.0%, abdominal obesity 63.4%, hypertension 67.5%, high fat diet 14.5%, low fruits/vegetables 31.8%, low fiber intake 60.0%, high salt diet 16.9%, physical inactivity 27.5%, coronary or cerebrovascular disease 3.0%, and microvascular disease (peripheral, ocular or renal) in 20.7%. Microvascular disease was significantly greater in illiterate (25.9%) and low (23.6%) compared to middle (15.0%) and high (14.7%) ES groups (P < 0.05). Age- and sex-adjusted logistic regression analysis revealed that in illiterate and low ES groups respectively, prevalence of smoking/tobacco use (odds ratio 3.84, confidence interval: 09–7.05 and 2.15, 1.36–3.41); low fruit/vegetable (2.51, 1.53–4.14 and 1.99, 1.30–3.04) and low fiber intake (4.02, 2.50–6.45 and 1.78, 1.23–2.59) was greater compared to high ES. Poor diabetes control (HbA1c >.0%) was significantly greater in illiterate (38.0%), low (46.0%), and middle (41.0%) compared to high (31.5%) ES subjects (P < 0.05). Conclusions: There is a greater prevalence of the microvascular disease in illiterate and low ES diabetes patients in India. This is associated with the higher prevalence of smoking/tobacco use, poor quality diet, and sub-optimal diabetes control.


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