The Influence of Age, Sex, and Socioeconomic Status on Glycemic Control Among People With Type 1 and Type 2 Diabetes in Canada: Patient-Led Longitudinal Retrospective Cross-sectional Study With Multiple Time Points of Measurement.

Autor: Mousavi S; Diabetes Action Canada, Toronto, ON, Canada.; VITAM Research Centre in Sustainable Health, Québec, QC, Canada.; Université Laval, Québec, QC, Canada., Tannenbaum Greenberg D; Diabetes Action Canada, Toronto, ON, Canada., Ndjaboué R; Diabetes Action Canada, Toronto, ON, Canada.; Centre de recherche sur le Vieillissement, Sherbrooke, QC, Canada.; School of Social Work, Faculty of Letters and Human Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada., Greiver M; Diabetes Action Canada, Toronto, ON, Canada.; Department of Family and Community Medicine, North York General Hospital, Toronto, ON, Canada.; Department of Family and Community Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada., Drescher O; Diabetes Action Canada, Toronto, ON, Canada., Chipenda Dansokho S; Diabetes Action Canada, Toronto, ON, Canada.; Office of Education and Professional Development, Faculty of Medicine, Université Laval, Québec, QC, Canada., Boutin D; Diabetes Action Canada, Toronto, ON, Canada.; Centre de recherche du CHUS, Sherbrooke, QC, Canada., Chouinard JM; Diabetes Action Canada, Toronto, ON, Canada., Dostie S; Diabetes Action Canada, Toronto, ON, Canada., Fenton R; Diabetes Action Canada, Toronto, ON, Canada.; National Indigenous Diabetes Association, Winnipeg, MB, Canada., Greenberg M; Diabetes Action Canada, Toronto, ON, Canada., McGavock J; Diabetes Action Canada, Toronto, ON, Canada.; Pediatrics and Child Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada., Najam A; Diabetes Action Canada, Toronto, ON, Canada., Rekik M; Diabetes Action Canada, Toronto, ON, Canada.; Department of Operations and Decision Systems, Faculty of Business Administration, Université Laval, Québec, QC, Canada.; Cardiometabolic Health, Diabetes and Obesity Research Network (CMDO), Sherbrooke, QC, Canada.; Interuniversity Research Centre of Enterprise Networks (CIRRELT), Montréal, QC, Canada., Weisz T; Diabetes Action Canada, Toronto, ON, Canada.; Wounds Canada, North York, ON, Canada.; Diabetes Canada, Toronto, ON, Canada., Willison DJ; Diabetes Action Canada, Toronto, ON, Canada.; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada., Durand A; Canada CIFAR AI Chair, Québec, QC, Canada.; Institute Intelligence and Data, Université Laval, Québec, QC, Canada.; Department of Computer Science and Software Engineering, Faculty of Science and Engineering, Université Laval, Québec, QC, Canada.; Department of Electrical Engineering and Computer Engineering, Faculty of Science and Engineering, Faculty of Science and Engineering, Québec, QC, Canada., Witteman HO; Diabetes Action Canada, Toronto, ON, Canada.; VITAM Research Centre in Sustainable Health, Québec, QC, Canada.; Office of Education and Professional Development, Faculty of Medicine, Université Laval, Québec, QC, Canada.; Department of Family and Emergency Medicine, Faculty of Medicine, Université Laval, Québec, QC, Canada.
Jazyk: angličtina
Zdroj: JMIR diabetes [JMIR Diabetes] 2023 Apr 27; Vol. 8, pp. e35682. Date of Electronic Publication: 2023 Apr 27.
DOI: 10.2196/35682
Abstrakt: Background: Clinical guidelines for most adults with diabetes recommend maintaining hemoglobin A 1c (HbA 1c ) levels ≤7% (≤53 mmol/mol) to avoid microvascular and macrovascular complications. People with diabetes of different ages, sexes, and socioeconomic statuses may differ in their ease of attaining this goal.
Objective: As a team of people with diabetes, researchers, and health professionals, we aimed to explore patterns in HbA 1c results among people with type 1 or type 2 diabetes in Canada. Our research question was identified by people living with diabetes.
Methods: In this patient-led retrospective cross-sectional study with multiple time points of measurement, we used generalized estimating equations to analyze the associations of age, sex, and socioeconomic status with 947,543 HbA 1c results collected from 2010 to 2019 among 90,770 people living with type 1 or type 2 diabetes in Canada and housed in the Canadian National Diabetes Repository. People living with diabetes reviewed and interpreted the results.
Results: HbA 1c results ≤7.0% represented 30.5% (male people living with type 1 diabetes), 21% (female people living with type 1 diabetes), 55% (male people living with type 2 diabetes) and 59% (female people living with type 2 diabetes) of results in each subcategory. We observed higher HbA 1c values during adolescence, and for people living with type 2 diabetes, among people living in lower income areas. Among those with type 1 diabetes, female people tended to have lower HbA 1c levels than male people during childbearing years but higher HbA 1c levels than male people during menopausal years. Team members living with diabetes confirmed that the patterns we observed reflected their own life courses and suggested that these results be communicated to health professionals and other stakeholders to improve the treatment for people living with diabetes.
Conclusions: A substantial proportion of people with diabetes in Canada may need additional support to reach or maintain the guideline-recommended glycemic control goals. Blood sugar management goals may be particularly challenging for people going through adolescence or menopause or those living with fewer financial resources. Health professionals should be aware of the challenging nature of glycemic management, and policy makers in Canada should provide more support for people with diabetes to live healthy lives.
(©Seyedmostafa Mousavi, Dana Tannenbaum Greenberg, Ruth Ndjaboué, Michelle Greiver, Olivia Drescher, Selma Chipenda Dansokho, Denis Boutin, Jean-Marc Chouinard, Sylvie Dostie, Robert Fenton, Marley Greenberg, Jonathan McGavock, Adhiyat Najam, Monia Rekik, Tom Weisz, Donald J Willison, Audrey Durand, Holly O Witteman, Diabetes Action Canada Research Questions Prioritization Study. Originally published in JMIR Diabetes (https://diabetes.jmir.org), 27.04.2023.)
Databáze: MEDLINE
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