IJE Advance Access originally published online on May 6, 2004
International Journal of Epidemiology 2004 33(4):864-871; doi:10.1093/ije/dyh089
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
IJE vol.33 no.4 © International Epidemiological Association 2004; all rights reserved.
Article |
Mortality and educational level among diabetic and non-diabetic population in the Turin Longitudinal Study: a 9-year follow-up
1 Epidemiology Unit, Local Health Authority 5 of Piedmont Region
2 Environmental Epidemiological Unit, Regional Environmental Protection Agency
3 Diabetes Regional Commission of Piedmont Region
4 University of Turin—Department of Public Health
Correspondence: Roberto Gnavi, ASL 5, Servizio di Epidemiologia, Via Sabaudia 164, 10095 Grugliasco (TO), Italy. E-mail: roberto.gnavi{at}epi.piemonte.it
Background People in a lower social position have a higher prevalence of unhealthy behaviour, more difficult access to healthcare, and lower compliance with drug treatment; as a consequence, social differences in mortality are likely to be higher in people with diabetes compared with the non-diabetic population. We compared diabetics with non-diabetics in terms of mortality and social differences in mortality.
Methods In all, 31 264 residents in Turin (northern Italy), who were 
20 years old, registered in the local diabetes register between 1991 and 1999. They were followed up from recruitment to December 1999, and their cause-specific mortality by educational level was analysed. This was compared with that of the local non-diabetic population. Diabetes was classified as type 1 (
35 years at diagnosis) or type 2 (>35 years).
Results For type 1 diabetes, the all-cause standardized mortality ratio (SMR) was 197.6 (95% CI:155.7, 247.4) in men and 336.0 (95% CI:259.3, 428.2) in women; for type 2 diabetes, the all-cause SMR was 142.8 (95% CI:138, 147.6) in men and 143.4 (95% CI:138.5, 148.5) in women. Whereas social differences in mortality were evident among non-diabetic men and women for all causes of death considered, no significant differences were found among diabetic women. Mortality was slightly increased among less educated diabetic men, particularly for neoplasms, although this gradient was less steep than that among non-diabetics.
Conclusions These results suggest that the regular clinical follow-up and health education provided by the local network of diabetic centres might play an important role in confronting the adverse effects of diabetes and in reducing social differences in health.
Keywords Diabetes mellitus, social class, mortality, Italy
Accepted 2 December 2003
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  R. Gnavi, R. Picariello, L. la Karaghiosoff, G. Costa, and C. Giorda Determinants of Quality in Diabetes Care Process: The population-based Torino Study Diabetes Care, November 1, 2009; 32(11): 1986 - 1992. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 The Antiretroviral Therapy Cohort Collaboration Mortality of HIV-infected patients starting potent antiretroviral therapy: comparison with the general population in nine industrialized countries Int. J. Epidemiol., October 9, 2009; (2009) dyp306v1. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Bihan, S. Laurent, C. Sass, G. Nguyen, C. Huot, J. J. Moulin, R. Guegen, P. Le Toumelin, H. Le Clesiau, E. La Rosa, et al. Association Among Individual Deprivation, Glycemic Control, and Diabetes Complications: The EPICES score Diabetes Care, November 1, 2005; 28(11): 2680 - 2685. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. D. Smith Infection, medical care and inequalities Int. J. Epidemiol., June 1, 2005; 34(3): 507 - 508. [Full Text] [PDF]
|
|