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Risk of Depression according to Cumulative Exposure to a Low-Household Income Status in Individuals with Type 2 Diabetes Mellitus: A Nationwide Population- Based Study
So Hee Park, You-Bin Lee, Kyu-na Lee, Bongsung Kim, So Hyun Cho, So Yoon Kwon, Jiyun Park, Gyuri Kim, Sang-Man Jin, Kyu Yeon Hur, Kyungdo Han, Jae Hyeon Kim
Diabetes Metab J. 2024;48(2):290-301.   Published online January 3, 2024
DOI: https://doi.org/10.4093/dmj.2022.0299
  • 1,347 View
  • 195 Download
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
We aimed to identify the risk of incident depression according to cumulative exposure to a low-household income status in individuals with type 2 diabetes mellitus (T2DM).
Methods
For this retrospective longitudinal population-based cohort study, we used Korean National Health Insurance Service data from 2002 to 2018. Risk of depression was assessed according to cumulative exposure to low-household income status (defined as Medical Aid registration) during the previous 5 years among adults (aged ≥20 years) with T2DM and without baseline depression who underwent health examinations from 2009 to 2012 (n=2,027,317).
Results
During an average 6.23 years of follow-up, 401,175 incident depression cases occurred. Advance in cumulative number of years registered for medical aid during the previous 5 years from baseline was associated with an increased risk of depression in a dose-dependent manner (hazard ratio [HR], 1.44 [95% confidence interval (CI), 1.38 to 1.50]; HR, 1.40 [95% CI, 1.35 to 1.46]; HR, 1.42, [95% CI, 1.37 to 1.48]; HR, 1.46, [95% CI, 1.40 to 1.53]; HR, 1.69, [95% CI, 1.63 to 1.74] in groups with 1 to 5 exposed years, respectively). Insulin users exposed for 5 years to a low-household income state had the highest risk of depression among groups categorized by insulin use and duration of low-household income status.
Conclusion
Cumulative duration of low-household income status, defined as medical aid registration, was associated with an increased risk of depression in a dose-response manner in individuals with T2DM.
Metabolic Risk/Epidemiology
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Low Household Income Status and Death from Pneumonia in People with Type 2 Diabetes Mellitus: A Nationwide Study
You-Bin Lee, So Hee Park, Kyu-na Lee, Bongsung Kim, So Yoon Kwon, Jiyun Park, Gyuri Kim, Sang-Man Jin, Kyu Yeon Hur, Kyungdo Han, Jae Hyeon Kim
Diabetes Metab J. 2023;47(5):682-692.   Published online June 22, 2023
DOI: https://doi.org/10.4093/dmj.2022.0184
  • 1,860 View
  • 127 Download
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
We explored the risk of death from pneumonia according to cumulative duration in low household income state (LHIS) among adults with type 2 diabetes mellitus (T2DM).
Methods
Using Korean National Health Insurance Service data (2002 to 2018), the hazards of mortality from pneumonia were analyzed according to duration in LHIS (being registered to Medical Aid) during the 5 years before baseline (0, 1–4, and 5 years) among adults with T2DM who underwent health examinations between 2009 and 2012 (n=2,503,581). Hazards of outcomes were also compared in six groups categorized by insulin use and duration in LHIS.
Results
During a median 7.18 years, 12,245 deaths from pneumonia occurred. Individuals who had been exposed to LHIS had higher hazards of death from pneumonia in a dose-response manner (hazard ratio [HR], 1.726; 95% confidence interval [CI], 1.568 to 1.899 and HR, 4.686; 95% CI, 3.948 to 5.562 in those exposed for 1–4 and 5 years, respectively) compared to the non-exposed reference. Insulin users exposed for 5 years to LHIS exhibited the highest outcome hazard among six groups categorized by insulin use and duration in LHIS.
Conclusion
Among adults with T2DM, cumulative duration in LHIS may predict increased risks of mortality from pneumonia in a graded dose-response manner. Insulin users with the longest duration in LHIS might be the group most vulnerable to death from pneumonia among adults with T2DM.
Clinical Care/Education
Impact of Socioeconomic Status on Health Behaviors, Metabolic Control, and Chronic Complications in Type 2 Diabetes Mellitus
So Hun Kim, Seung Youn Lee, Chei Won Kim, Young Ju Suh, Seongbin Hong, Seong Hee Ahn, Da Hae Seo, Moon-Suk Nam, Suk Chon, Jeong-Taek Woo, Sei Hyun Baik, Yongsoo Park, Kwan Woo Lee, Young Seol Kim
Diabetes Metab J. 2018;42(5):380-393.   Published online June 29, 2018
DOI: https://doi.org/10.4093/dmj.2017.0102
  • 5,150 View
  • 73 Download
  • 13 Web of Science
  • 16 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   
Background

The aim of the study was to assess the impact of socioeconomic status (SES) on health behaviors, metabolic control, and chronic complications in people with type 2 diabetes mellitus (T2DM) from South Korea, a country with universal health insurance coverage and that has experienced rapid economic and social transition.

Methods

A total of 3,294 Korean men and women with T2DM aged 30 to 65 years, participating in the Korean National Diabetes Program (KNDP) cohort who reported their SES and had baseline clinical evaluation were included in the current cross-sectional analysis. SES included the level of education and monthly household income.

Results

Lower education level and lower income level were closely related, and both were associated with older age in men and women. Women and men with lower income and education level had higher carbohydrate and lower fat intake. After adjustment for possible confounding factors, higher education in men significantly lowered the odds of having uncontrolled hyperglycemia (glycosylated hemoglobin ≥7.5%) (odds ratio [OR], 0.63; 95% confidence interval [CI], 0.43 to 0.91 for highest education; Ptrend=0.048), while higher household income in men significantly lowered the odds of having diabetic retinopathy (OR, 0.59; 95% CI, 0.37 to 0.95 for highest income level; Ptrend=0.048). In women, lower income was associated with a higher stress level.

Conclusion

Men with lower SES had higher odds of having diabetic retinopathy and uncontrolled hyperglycemia, showing the need to improve care targeted to this population.

Citations

Citations to this article as recorded by  
  • A Scoping Review of Possible Solutions for Decreasing Socioeconomic Inequalities in Type 2 Diabetes Mellitus
    Laleh Gharacheh, Mostafa Amini-Rarani, Amin Torabipour, Saeed Karimi
    International Journal of Preventive Medicine.2024;[Epub]     CrossRef
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    Chandana Wijeweera, Ummul Muhfaza, Reginald V. Lord, Peter Petocz, Juliana Chen, Veronica Preda
    Primary Care Diabetes.2024; 18(3): 308.     CrossRef
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    European Heart Journal.2024; 45(21): 1920.     CrossRef
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    Acta Diabetologica.2024;[Epub]     CrossRef
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    Nutrition.2023; 105: 111805.     CrossRef
  • Sustained Low Income, Income Changes, and Risk of All-Cause Mortality in Individuals With Type 2 Diabetes: A Nationwide Population-Based Cohort Study
    Hong Seok Lee, Jimin Clara Park, Inkwan Chung, Junxiu Liu, Seong-Su Lee, Kyungdo Han
    Diabetes Care.2023; 46(1): 92.     CrossRef
  • Association of birth weight with risk of diabetes mellitus in adolescence and early adulthood: analysis of the Indonesian Family Life Survey
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  • Effects of Diabetes Quality Assessment on Diabetes Management Behaviors Based on a Nationwide Survey
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    International Journal of Environmental Research and Public Health.2022; 19(23): 15781.     CrossRef
  • FOLLOW-UP ADHERENCE IN PATIENTS WITH NONPROLIFERATIVE DIABETIC RETINOPATHY PRESENTING TO AN OPHTHALMIC EMERGENCY DEPARTMENT
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    Retina.2021; 41(6): 1293.     CrossRef
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    Małgorzata Elżbieta Zujko, Anna Waśkiewicz, Wojciech Drygas, Alicja Cicha-Mikołajczyk, Kinga Zujko, Danuta Szcześniewska, Krystyna Kozakiewicz, Anna Maria Witkowska
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