Diabetes is a chronic disease whose associated comorbidities are largely influenced not only by pathology but also by socio-economic conditions. The aim of this study is to investigate the influence of social conditions on the evolution of diabetes. A retrospective, comparative study of 111 patients with type 2 diabetes Follow-up in the Endocrinology-Diabetology department in hospital Hedi Chaker of Sfax. Patients were divided into two groups with unfavorable (G1) and good (G2) socio-economic conditions, both groups had 58 and 53 patients, respectively. The average age of our patients was 54 in G1 and 49 in G2 (P=0.7). A female predominance was noted in the G 1/64% while the male sex was predominant in the G 2: 80%. The age of diabetes was comparable between the two groups (12.5 years vs 11 years, P=0.09). Fasting glucose was significantly higher in G 1 (15 mmol / l) versus 9 mmol / l in G2 (P<0.0001). The number of hospitalizations was higher in G1: 2.8 versus 1.3 in G2 (P=0.005). The food investigation showed a higher caloric intake in G2 estimated at 2615 Kcal/d versus 2184 Kcal/d for the G1. Infectious complications and amputation were significantly more frequent in G 1 compared to G2. Similarly, microangiopathic complications were more frequent in G1 patients. This imbalance was related to management difficulties, so no patient of G1 group was placed under insulin analogs versus 23% of G2 patients. Socioeconomic status seems to play a crucial role in the glycemic balance and the occurrence of chronic complications of diabetes. This is mainly due to the restriction of access to health care structures and therapeutic, sometimes expensive, and the level of instruction of these disadvantaged classes.
20 - 23 May 2017
European Society of Endocrinology