Endocrine Abstracts (2012) 29 P580

Association between educational level with glycemic and risk factor control in type 1 diabetes: results from DIACAM 1 study

J Sastre1, P Pines2, J Moreno3, I Quiroga4, M Delagado5, D Calderon6, S Herranz7, J Lozano2 & J Lopez1


1Complejo Hospitalario de Toledo, Toledo, Spain; 2Complejo Hospitalario de Albacete, Albacete, Spain; 3Complejo Hospitalario Mancha Centro, Alcazar de San Juan, Spain; 4Hospital Nuestra Señora del Prado, Talavera de la Reina, Spain; 5Hospital General de Ciudad Real, Ciudad Real, Spain; 6Hospital Virgen de la Luz, Cuenca, Spain; 7Hospital Universitario de Guadalajara, Guadalajara, Spain.


Objective and aims: This study was designed to investigate the clinical characteristics of a representative group of type 1 diabetic (T1D) population in Castilla La Mancha, a region in central Spain. The aim of this report is to evaluate the relationship between the educational level and cardiometabolic risk in adult patients with T1D.

Patients and methods: This is an observational, cross-sectional, prospective and multicentre study of 1465 patients who received attention along 2010. From this cohort patients aged >25 years were analyzed (n:1130, 48% women, mean age 42.9±11.6 years and mean diabetes duration: 20.9±0.9 years). Educational levels were classified as low (no studies or primary school, n:541 (47.9%)), middle (high school, n:347 (30.7%)) or high (university, n:242 (21.4%)). Diabetic patients underwent clinical and laboratory evaluation. A multivariate logistic regression analysis was used to asses the influence of educational status in good glycemic control (HbA1c ≥7%).

Results: There was no difference between groups regarding gender, but patients with low educational level (LEL) were older and had longer duration of diabetes (P<0.001). The prevalence of cardiovascular risk factors was higher in patients with LEL (Table). The prevalence of metabolic syndrome (IDF criteria) was higher in patients with LEL versus high (39.7 vs 21.5%, P<0.001). Glycemic control was worse in patients with LEL (HbA1c 8.1±1.2 vs 7.3±1.0%, P<0.001). There were no differences in lipid and pressure control between groups (except for HDLc and systolic blood pressure) but antihypertensive and lipid-lowering treatments were more prevalent in LEL group. After adjusting for diabetes duration, LEL was inversely associated with good glycemic control (OR 0.7 95% CI: 0.5–0.9, P<0.01).

Conclusions: In this cohort of adult TID patients, LEL is associated poor glycemic control and higher prevalence of cardiovascular risk factors, these patients should receive adecuate follow-up to reduce their risk of complications.

Table 1 Prevalence of classic cardiovascular risk factors according to educational level
LowMiddleHighP
Hypertension (%)32.524.214.0<0.001
Dyslipidemia (%)46.238.228.5<0.001
Obesity (%)20.913.413.6<0.01
Smoking (%)29.628.219.0<0.01

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.

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