KDA
- Current
- Browse
- Collections
-
For contributors
- For Authors
- Instructions for authors
- Article processing charge
- For Reviewers
- Instructions for reviewers
- How to become a reviewer
- Best reviewers
- For Readers
- Readership
- Subscription
- Permission guidelines
- About
- Editorial policy
Search
- Page Path
- HOME > Search
Response
- Social Determinants of Health and Cardiovascular Risk among Adults with Diabetes: The Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study (Diabetes Metab J 2024;48:1073-83)
- Lisa Zhang, Monika M. Safford
- Diabetes Metab J. 2025;49(4):910-911. Published online July 1, 2025
- DOI: https://doi.org/10.4093/dmj.2025.0383
- 1,757 View
- 28 Download
Original Article
- Cardiovascular Risk/Epidemiology
- Social Determinants of Health and Cardiovascular Risk among Adults with Diabetes: The Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study
- Lisa Zhang, Evgeniya Reshetnyak, Joanna B. Ringel, Laura C. Pinheiro, April Carson, Doyle M. Cummings, Raegan W. Durant, Gargya Malla, Monika M. Safford
- Diabetes Metab J. 2024;48(6):1073-1083. Published online July 22, 2024
- DOI: https://doi.org/10.4093/dmj.2023.0380
- 7,418 View
- 206 Download
- 8 Web of Science
- 6 Crossref
-
Abstract
PDF
Supplementary Material
PubReader 
ePub - Background
Social determinants of health (SDOH) have been associated with diabetes risk; however, their association with cardiovascular disease (CVD) events in individuals with diabetes is poorly described. We hypothesized that a greater number of SDOH among individuals with diabetes would be associated with a higher risk of CVD events.
Methods
The REasons for Geographic and Racial Differences in Stroke (REGARDS) study is a national, biracial cohort of 30,239 individuals ≥45 years old recruited in 2003–2007. We included 6,322 participants with diabetes at baseline, defined as healthcare professional diagnosis, diabetes medication use, or blood glucose values. Seven SDOH that were individually associated with CVD events were included (P<0.20). The outcome was CVD events, a composite of expert-adjudicated myocardial infarction, stroke, or cardiovascular death. We estimated Cox proportional hazard models to examine associations between number of SDOH (0, 1, 2, ≥3) and CVD events.
Results
In an age and sex adjusted model, the presence of multiple SDOH significantly increased the risk of any CVD event (hazard ratio [HR], 1.48; 95% confidence interval [CI], 1.26 to 1.74 for two SDOH; HR, 1.68; 95% CI, 1.43 to 1.96 for ≥3 SDOH). This finding was attenuated but remained statistically significant in a fully adjusted model (HR, 1.19; 95% CI, 1.01 to 1.40 for two SDOH; HR, 1.27; 95% CI, 1.07 to 1.50 for ≥3 SDOH).
Conclusion
Having multiple SDOH was independently associated with an increased risk of CVD events, a finding driven by cardiovascular death. Identifying individuals with diabetes who have multiple SDOH may be helpful for detecting those at higher risk of experiencing or dying from CVD events. -
Citations
Citations to this article as recorded by
- Tailoring interventions to close gaps in diabetes mellitus care
Alicia Diaz-Thomas, Susanne Cabrera, Rocio I. Pereira, Pallavi Iyer
Nature Reviews Endocrinology.2026; 22(6): 356. CrossRef - Social determinants of health and stroke risk: A dose–response analysis of cumulative socioeconomic burden in US adults
Jianghong Wang, Cailiu Wei, Xiaoyan Hu, Linlin Cai, Sanmeizi Xie
Neurological Sciences.2026;[Epub] CrossRef - A Case-Based Analysis of Social Drivers in Diabetes Outcomes
Katherine E. Matics
The Journal for Nurse Practitioners.2026; 22(5): 105761. CrossRef - Associations of Social Determinants and Lifestyle Factors With Incidence and Dynamic Progression of Type 2 Diabetes in the Chinese Population
Yanqiu Zou, Yan Su, Yanlin Chen, Xintong Duan, Xia Jiang, Ben Zhang, Bang Zheng, Mengyu Fan
Diabetes, Obesity and Metabolism.2026;[Epub] CrossRef - The impact of social determinants of health on diabetic gastroparesis: a retrospective analysis
Ioana Soare, Nicoleta Andreea Tudose, Claudia Simona Stefan, Roxana Elena Mirică
Frontiers in Public Health.2025;[Epub] CrossRef - Hypertriglyceridemic waist phenotype in relation to diabetes mellitus and cardiovascular diseases in the Indonesian and Korean populations: evidence from two national surveys
Fathimah S. Sigit, Sinyoung Cho, Farid Kurniawan, Hye-Ryeong Jeon, Ratu Ayu Dewi Sartika, Dicky L. Tahapary, Hyuktae Kwon
Diabetology & Metabolic Syndrome.2025;[Epub] CrossRef
- Tailoring interventions to close gaps in diabetes mellitus care
First
Prev
