Doreen M. Rabi|Alun Edwards|Larry Svenson|Peter Sargious|Peter Norton|Erik T. Larsen|William A. Ghali
Clinical and medication profiles stratified by household income in patients referred for diabetes care
University of Calgary|University of Calgary|Alberta Health|University of Calgary|University of Calgary|Calgary Laboratory Services|University of Calgary
abstract background low income individuals diabetes particularly high risk poor health outcomes specialized diabetes care may help reduce risk currently known whether significant clinical differences across income groups time referral objective study determine clinical profiles medication use patients referred diabetes care differ across income quintiles methods crosssectional study conducted using canadian urban diabetes education centre dec database clinical information 4687 patients referred dec may 2000 january 2002 examined data merged 2001 canadian census data income potential differences continuous clinical parameters across income quintiles examined using regression models differences medication use examined using chi square analyses results multivariate regression analysis indicated income negatively associated bmi p lt 00005 age p 0023 time referral highest income quintiles found lower serum triglycerides p 0011 higher hdlc p 0008 time referral significant differences found hba1c ldlc duration diabetes chi square analysis medication use revealed despite significant differences hba1c lowest income quintiles used metformin p 0001 sulfonylureas p lt 00005 wealthy use therapies similar across income groups including lipid lowering medications high income patients likely treated diet alone p lt 00005 conclusion findings demonstrate low income patients present diabetes clinic older heavier atherogenic lipid profile high income patients overall medication use higher among lower income group suggesting differences clinical profiles result undertreatment thus invoking lifestyle factors potential contributors findings