Korean Diabetes J.  2008 Aug;32(4):377-385. 10.4093/kdj.2008.32.4.377.

Association of Educational Level and Socioeconomic Status with Glucose Metabolism

Affiliations
  • 1Department of Internal Medicine, Gachon University of Medicine and Science, Korea.
  • 2Department of Preventive Medicine, Gachon University of Medicine and Science, Korea.
  • 3Department of Internal Medicine, Inha University College of Medicine, Korea.

Abstract

BACKGROUND: The objective of the present study was to examine the association of educational level and socioeconomic status with glucose metabolism including prediabetes.
METHODS
This cross-sectional study subjects were 882 (mean age: 51.0 +/- 13.4 years, M:F = 241:641) without diabetes, aged more than 20 years and residing in Whasu 2 dong in Incheon. We classified them into three levels according to their educational level: primary (illiterate or up to elementary school), secondary (middle school or high school) and tertiary (university), and into three levels according to their socioeconomic status by self reported questionnaire: low, middle and high. Subjects were diagnosed as three groups (normal, prediabetes and diabetes) by American Diabetes Association criteria using 75 g oral glucose tolerance test. The association of educational level and socioeconomic status with glucose metabolism was analyzed.
RESULTS
The number of normal group was 300 (34.0%), that of prediabetes was 470 (53.3%) and that of diabetes was 112 (12.7%). In women, the proportion of primary educational group was larger than that of secondary educational group in diabetes (Odds ratio [OR] = 1.88; 95% confidence interval [CI]: 1.01-3.51) and larger than that of tertiary educational group in prediabetes ([OR] = 2.00; [CI]: 1.06-3.78). But socioeconomic status did not have the statistical association with glucose metabolism in women. Also both educational level and socioeconomic status had no statistical association with glucose metabolism in men.
CONCLUSIONS
The proportion of low educational level is larger in prediabetes and diabetes compared with normal group in women.

Keyword

Diabetes; Educational level; Prediabetes; Socioeconomic status

MeSH Terms

Aged
Cross-Sectional Studies
Female
Glucose
Glucose Tolerance Test
Humans
Prediabetic State
Self Report
Social Class
Glucose

Reference

4. Harris MI, Flegal KM, Cowie CC, Eberhardt MS, Goldstein DE, Little RR, Wiedmeyer HM, Byrd-Holt DD. Prevalence of diabetes, impaired fasting glucose, and impaired glucose tolerance in U.S. adults. Diabetes Care. 1996. 21:518–524.
5. Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes. Diabetes Care. 2004. 27:1047–1053.
6. Zimmet PZ. Challenges in diabetes epidemiology-from West to the rest. Diabetes Care. 1992. 15:232–252.
7. Agardh EE, Ahlbom A, Andersson T, Efendic S, Grill V, Hallqvist J, Ostenson CG. Socio-economic position at three points in life in association with type 2 diabetes and impaired glucose tolerance in middle-aged Swedish men and women. Int J Epidemiol. 2007. 36:84–92.
8. Ko GT, Chan JC, Yeung VT, Chow CC, Tsang LW, Cockram CS. A low socio-economic status is an additional risk factor for glucose intolerance in high risk Hong Kong Chinese. Eur J of Epidemiol. 2001. 17:289–295.
9. Rabi DM, Edwards AL, Southern DA, Svenson LW, Sargious PM, Norton P, Larsen ET, Ghali WA. Association of socio-economic status with diabetes prevalence and utilization of diabetes care service. BMC Health Serv Res. 2006. 6:124.
10. Robbins JM, Vaccarino V, Zhang H, Kasl SV. Socioeconomic status and type 2 diabetes in African American and Non-Hispanic white women and men: Evidence from the third national health and nutrition examination survey. Am J Public Health. 2001. 91:76–83.
11. Beckles GLA, Thompson-Reid PE. Socioeconomic status of women with diabetes-Unites States, 2000. MMWR. 2002. 51:147–159.
12. Nathan DM, Davidson MB, DeFronzo RA, Heine RJ, Henry RR, Pratley R, Zinman B. Impaired fasting glucose and impaired glucose tolerance : implications for care. Diabetes care. 2007. 30:753–759.
13. Benjamin SM, Valdez R, Geiss LS, Rolka DB, Narayan KM. Estimated number of adults with prediabetes in the US in 2000: Opportunities for prevention. Diabetes Care. 2003. 26:645–649.
14. Abdul-Ghani MA, Tripathy D, DeFronzo RA. Contributions of beta-cell dysfunction and insulin resistance to the pathogenesis of impaired glucose tolerance and impaired fasting glucose. Diabetes Care. 2006. 29:1130–1139.
15. Dunstan DW, Zimmet PZ, Welborn TA, De Courten MP, Cameron AJ, Sicree RA, Dwyer T, Colagiuri S, Jolley D, Knuiman M, Atkins R, Shaw JE. The Australian Diabetes, Obesity and Lifestyle Study. The rising prevalence of diabetes and impaired glucose tolerance. Diabetes Care. 2002. 25:829–834.
16. Tuomilehto J, Lindstrom J, Eriksson JG, Valle TT, Hamalainen H, Ilanne-Parikka P, Keinanen-Kiukaanniemi S, Laakso M, Louheranta A, Rastas M, Salminen V, Uusitupa M. Finnish Diabetes Prevention Study Group: Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med. 2001. 344:1343–1350.
17. Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, Nathan DM. Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002. 346:393–403.
18. Ramachandran A, Snehalatha C, Marry S, Mukesh B, Bhaskar AD, Vijay V. Indian Diabetes Prevention Programme (IDPP). The Indian Diabetes Prevention Programme shows that lifestyle modification and metformin prevent type 2 diabetes in Asian Indian Subjects with impaired glucose tolerance (IDDP-1). Diabetolgia. 2006. 49:289–297.
19. DECODE Study Group. the European Diabetes Epidemiology Group. Glucose tolerance and cardiovascular mortality: comparison of fasting and 2-hour diagnostic criteria. Arch Intern Med. 2001. 161:397–405.
20. Coutinho M, Gerstein HC, Wang Y, Yusuf S. The relationship between glucose and incident cardiovascular events. A metaregression analysis of published data from 20 studies of 95,783 individuals followed for 12.4 years. Diabetes Care. 1999. 22:233–240.
21. Liao D, Shofer JB, Boyko EJ, McNeely M, Leonetti DL, Kahn SE, Fujimoto WY. Abnormal glucose tolerance and increased risk for cardiovascular disease in Japanese-Americans with normal fasting glucose. Diabetes Care. 2001. 24:39–44.
22. Bjornholt JV, Erikssen G, Aaser E, Sandvik L, Nitter-Hauge S, Jervell J, Erikssen J, Thaulow E. Fasting blood glucose : an underestimated risk factor for cardiovascular death. Results from a 22-year follow-up for healthy nondiabetic men. Diabetes Care. 1999. 22:45–49.
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