Large socioeconomic gap in period life expectancy and life years spent with complications of diabetes in the Scottish population with type 1 diabetes, 2013–2018

SDRNEpi Group

doi:10.1371/journal.pone.0271110

Large socioeconomic gap in period life expectancy and life years spent with complications of diabetes in the Scottish population with type 1 diabetes, 2013–2018

SDRNEpi Group

Applied Health Sciences

Research output: Contribution to journal › Article › peer-review

3 Citations (Scopus)

1 Downloads (Pure)

Abstract

Background We report the first study to estimate the socioeconomic gap in period life expectancy (LE) and life years spent with and without complications in a national cohort of individuals with type 1 diabetes. Methods This retrospective cohort study used linked healthcare records from SCI-Diabetes, the population-based diabetes register of Scotland. We studied all individuals aged 50 and older with a diagnosis of type 1 diabetes who were alive and residing in Scotland on 1 January 2013 (N = 8591). We used the Scottish Index of Multiple Deprivation (SIMD) 2016 as an area-based measure of socioeconomic deprivation. For each individual, we constructed a history of transitions by capturing whether individuals developed retinopathy/maculopathy, cardiovascular disease, chronic kidney disease, and diabetic foot, or died throughout the study period, which lasted until 31 December 2018. Using parametric multistate survival models, we estimated total and state-specific LE at an attained age of 50. Results At age 50, remaining LE was 22.2 years (95% confidence interval (95% CI): 21.6 - 22.8) for males and 25.1 years (95% CI: 24.4 - 25.9) for females. Remaining LE at age 50 was around 8 years lower among the most deprived SIMD quintile when compared with the least deprived SIMD quintile: 18.7 years (95% CI: 17.5 - 19.9) vs. 26.3 years (95% CI: 24.5 - 28.1) among males, and 21.2 years (95% CI: 19.7 - 22.7) vs. 29.3 years (95% CI: 27.5 - 31.1) among females. The gap in life years spent without complications was around 5 years between the most and the least deprived SIMD quintile: 4.9 years (95% CI: 3.6 - 6.1) vs. 9.3 years (95% CI: 7.5 - 11.1) among males, and 5.3 years (95% CI: 3.7 - 6.9) vs. 10.3 years (95% CI: 8.3 - 12.3) among females. SIMD differences in transition rates decreased marginally when controlling for time-updated information on risk factors such as HbA1c, blood pressure, BMI, or smoking. Conclusions In addition to societal interventions, tailored support to reduce the impact of diabetes is needed for individuals from low socioeconomic backgrounds, including access to innovations in management of diabetes and the prevention of complications.

Original language	English
Article number	e0271110
Number of pages	21
Journal	PloS ONE
Volume	17
Issue number	8
Early online date	11 Aug 2022
DOIs	https://doi.org/10.1371/journal.pone.0271110
Publication status	Published - Aug 2022

Bibliographical note

Funding Information:
This study was supported by funding from Diabetes UK. In particular the following grants: 17/0005627 - received by HMC 8/0005786 - received by TMC. The funder had no role in designing the study or in analysing and interpreting data and results.

Data Availability Statement

The analysed data were provided de-identified, with approval from the Public Benefit and Privacy Panel (PBPP refs. 1617-0147), originally set up under Privacy Advisory Committee (PAC) 33/11, with approval from the Scotland A Research Ethics Committee (ref. 11/AL/0225). NHS data governance rules do not permit us to secondarily share the analysed data directly. However, bona fide researchers can apply to the Scottish Public Benefits Protection Committee for access to these data or get in contact with the Scottish Diabetes Research Network in order to gain further information on the data and legislations surrounding the access to the data. The Scottish Diabetes Research Network can be contacted via the following address: Diabetes Support Unit, Level 8, Ninewells Hospital, Dundee DD1 9SY, email: administrator-sdrn@dundee.ac.uk. The Scottish Public Benefits Protection Committee provided detailed information and instructions on data access requests here: https://www.informationgovernance.scot.nhs.uk/pbpphsc/ and be contacted via the following email address: phs.edris@phs.scot. For further information on NHS Scotland diabetes data provisioning see: https://www.nhsresearchscotland.org.uk/research-areas/diabetes/training-and-events. The corresponding author can be contacted for any further genuine requests to audit the validity of the analyses. We are happy to share summary statistics for those wishing to conduct meta-analyses with other studies.

Keywords

Aged
Diabetes Complications/complications
Diabetes Mellitus, Type 1/complications
Female
Humans
Life Expectancy
Male
Middle Aged
Retrospective Studies
Scotland/epidemiology
Socioeconomic Factors

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1371/journal.pone.0271110Licence: CC BY

Hohn_et_al_Large_socioeconomic_PlosOne_vor
Copyright: © 2022 Höhn et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. https://creativecommons.org/licenses/by/4.0/
Final published version, 1.6 MBLicence: CC BY

Cite this

@article{bf6208e416ba44bf854f38b9063f7adf,

title = "Large socioeconomic gap in period life expectancy and life years spent with complications of diabetes in the Scottish population with type 1 diabetes, 2013–2018",

abstract = "Background We report the first study to estimate the socioeconomic gap in period life expectancy (LE) and life years spent with and without complications in a national cohort of individuals with type 1 diabetes. Methods This retrospective cohort study used linked healthcare records from SCI-Diabetes, the population-based diabetes register of Scotland. We studied all individuals aged 50 and older with a diagnosis of type 1 diabetes who were alive and residing in Scotland on 1 January 2013 (N = 8591). We used the Scottish Index of Multiple Deprivation (SIMD) 2016 as an area-based measure of socioeconomic deprivation. For each individual, we constructed a history of transitions by capturing whether individuals developed retinopathy/maculopathy, cardiovascular disease, chronic kidney disease, and diabetic foot, or died throughout the study period, which lasted until 31 December 2018. Using parametric multistate survival models, we estimated total and state-specific LE at an attained age of 50. Results At age 50, remaining LE was 22.2 years (95% confidence interval (95% CI): 21.6 - 22.8) for males and 25.1 years (95% CI: 24.4 - 25.9) for females. Remaining LE at age 50 was around 8 years lower among the most deprived SIMD quintile when compared with the least deprived SIMD quintile: 18.7 years (95% CI: 17.5 - 19.9) vs. 26.3 years (95% CI: 24.5 - 28.1) among males, and 21.2 years (95% CI: 19.7 - 22.7) vs. 29.3 years (95% CI: 27.5 - 31.1) among females. The gap in life years spent without complications was around 5 years between the most and the least deprived SIMD quintile: 4.9 years (95% CI: 3.6 - 6.1) vs. 9.3 years (95% CI: 7.5 - 11.1) among males, and 5.3 years (95% CI: 3.7 - 6.9) vs. 10.3 years (95% CI: 8.3 - 12.3) among females. SIMD differences in transition rates decreased marginally when controlling for time-updated information on risk factors such as HbA1c, blood pressure, BMI, or smoking. Conclusions In addition to societal interventions, tailored support to reduce the impact of diabetes is needed for individuals from low socioeconomic backgrounds, including access to innovations in management of diabetes and the prevention of complications.",

keywords = "Aged, Diabetes Complications/complications, Diabetes Mellitus, Type 1/complications, Female, Humans, Life Expectancy, Male, Middle Aged, Retrospective Studies, Scotland/epidemiology, Socioeconomic Factors",

author = "Andreas H{\"o}hn and McGurnaghan, {Stuart J.} and Caparrotta, {Thomas M.} and Anita Jeyam and O{\textquoteright}Reilly, {Joseph E.} and Blackbourn, {Luke A.K.} and Sara Hatam and Christian Dudel and Seaman, {Rosie J.} and Joseph Mellor and Naveed Sattar and McCrimmon, {Rory J.} and Brian Kennon and Petrie, {John R.} and Sarah Wild and McKeigue, {Paul M.} and Colhoun, {Helen M.} and J. Chalmers and C. Fischbacher and G. Leese and R. Lindsay and J. McKnight and S. Philip and D. McAllister and E. Pearson and {SDRNEpi Group}",

note = "Funding Information: This study was supported by funding from Diabetes UK. In particular the following grants: 17/0005627 - received by HMC 8/0005786 - received by TMC. The funder had no role in designing the study or in analysing and interpreting data and results. ",

year = "2022",

month = aug,

doi = "10.1371/journal.pone.0271110",

language = "English",

volume = "17",

journal = "PloS ONE",

issn = "1932-6203",

publisher = "PUBLIC LIBRARY SCIENCE",

number = "8 ",

}

TY - JOUR

T1 - Large socioeconomic gap in period life expectancy and life years spent with complications of diabetes in the Scottish population with type 1 diabetes, 2013–2018

AU - Höhn, Andreas

AU - McGurnaghan, Stuart J.

AU - Caparrotta, Thomas M.

AU - Jeyam, Anita

AU - O’Reilly, Joseph E.

AU - Blackbourn, Luke A.K.

AU - Hatam, Sara

AU - Dudel, Christian

AU - Seaman, Rosie J.

AU - Mellor, Joseph

AU - Sattar, Naveed

AU - McCrimmon, Rory J.

AU - Kennon, Brian

AU - Petrie, John R.

AU - Wild, Sarah

AU - McKeigue, Paul M.

AU - Colhoun, Helen M.

AU - Chalmers, J.

AU - Fischbacher, C.

AU - Leese, G.

AU - Lindsay, R.

AU - McKnight, J.

AU - Philip, S.

AU - McAllister, D.

AU - Pearson, E.

AU - SDRNEpi Group

N1 - Funding Information: This study was supported by funding from Diabetes UK. In particular the following grants: 17/0005627 - received by HMC 8/0005786 - received by TMC. The funder had no role in designing the study or in analysing and interpreting data and results.

PY - 2022/8

Y1 - 2022/8

N2 - Background We report the first study to estimate the socioeconomic gap in period life expectancy (LE) and life years spent with and without complications in a national cohort of individuals with type 1 diabetes. Methods This retrospective cohort study used linked healthcare records from SCI-Diabetes, the population-based diabetes register of Scotland. We studied all individuals aged 50 and older with a diagnosis of type 1 diabetes who were alive and residing in Scotland on 1 January 2013 (N = 8591). We used the Scottish Index of Multiple Deprivation (SIMD) 2016 as an area-based measure of socioeconomic deprivation. For each individual, we constructed a history of transitions by capturing whether individuals developed retinopathy/maculopathy, cardiovascular disease, chronic kidney disease, and diabetic foot, or died throughout the study period, which lasted until 31 December 2018. Using parametric multistate survival models, we estimated total and state-specific LE at an attained age of 50. Results At age 50, remaining LE was 22.2 years (95% confidence interval (95% CI): 21.6 - 22.8) for males and 25.1 years (95% CI: 24.4 - 25.9) for females. Remaining LE at age 50 was around 8 years lower among the most deprived SIMD quintile when compared with the least deprived SIMD quintile: 18.7 years (95% CI: 17.5 - 19.9) vs. 26.3 years (95% CI: 24.5 - 28.1) among males, and 21.2 years (95% CI: 19.7 - 22.7) vs. 29.3 years (95% CI: 27.5 - 31.1) among females. The gap in life years spent without complications was around 5 years between the most and the least deprived SIMD quintile: 4.9 years (95% CI: 3.6 - 6.1) vs. 9.3 years (95% CI: 7.5 - 11.1) among males, and 5.3 years (95% CI: 3.7 - 6.9) vs. 10.3 years (95% CI: 8.3 - 12.3) among females. SIMD differences in transition rates decreased marginally when controlling for time-updated information on risk factors such as HbA1c, blood pressure, BMI, or smoking. Conclusions In addition to societal interventions, tailored support to reduce the impact of diabetes is needed for individuals from low socioeconomic backgrounds, including access to innovations in management of diabetes and the prevention of complications.

AB - Background We report the first study to estimate the socioeconomic gap in period life expectancy (LE) and life years spent with and without complications in a national cohort of individuals with type 1 diabetes. Methods This retrospective cohort study used linked healthcare records from SCI-Diabetes, the population-based diabetes register of Scotland. We studied all individuals aged 50 and older with a diagnosis of type 1 diabetes who were alive and residing in Scotland on 1 January 2013 (N = 8591). We used the Scottish Index of Multiple Deprivation (SIMD) 2016 as an area-based measure of socioeconomic deprivation. For each individual, we constructed a history of transitions by capturing whether individuals developed retinopathy/maculopathy, cardiovascular disease, chronic kidney disease, and diabetic foot, or died throughout the study period, which lasted until 31 December 2018. Using parametric multistate survival models, we estimated total and state-specific LE at an attained age of 50. Results At age 50, remaining LE was 22.2 years (95% confidence interval (95% CI): 21.6 - 22.8) for males and 25.1 years (95% CI: 24.4 - 25.9) for females. Remaining LE at age 50 was around 8 years lower among the most deprived SIMD quintile when compared with the least deprived SIMD quintile: 18.7 years (95% CI: 17.5 - 19.9) vs. 26.3 years (95% CI: 24.5 - 28.1) among males, and 21.2 years (95% CI: 19.7 - 22.7) vs. 29.3 years (95% CI: 27.5 - 31.1) among females. The gap in life years spent without complications was around 5 years between the most and the least deprived SIMD quintile: 4.9 years (95% CI: 3.6 - 6.1) vs. 9.3 years (95% CI: 7.5 - 11.1) among males, and 5.3 years (95% CI: 3.7 - 6.9) vs. 10.3 years (95% CI: 8.3 - 12.3) among females. SIMD differences in transition rates decreased marginally when controlling for time-updated information on risk factors such as HbA1c, blood pressure, BMI, or smoking. Conclusions In addition to societal interventions, tailored support to reduce the impact of diabetes is needed for individuals from low socioeconomic backgrounds, including access to innovations in management of diabetes and the prevention of complications.

KW - Aged

KW - Diabetes Complications/complications

KW - Diabetes Mellitus, Type 1/complications

KW - Female

KW - Humans

KW - Life Expectancy

KW - Male

KW - Middle Aged

KW - Retrospective Studies

KW - Scotland/epidemiology

KW - Socioeconomic Factors

UR - http://www.scopus.com/inward/record.url?scp=85136311883&partnerID=8YFLogxK

U2 - 10.1371/journal.pone.0271110

DO - 10.1371/journal.pone.0271110

M3 - Article

C2 - 35951518

AN - SCOPUS:85136311883

SN - 1932-6203

VL - 17

JO - PloS ONE

JF - PloS ONE

IS - 8

M1 - e0271110

ER -

Large socioeconomic gap in period life expectancy and life years spent with complications of diabetes in the Scottish population with type 1 diabetes, 2013–2018

Abstract

Bibliographical note

Data Availability Statement

Keywords

UN SDGs

Access to Document

Other files and links

Fingerprint

Cite this