A socioeconomic and behavioral survey of patients with difficult-to-control type 2 diabetes mellitus reveals an association between diabetic retinopathy and educational attainment.
A socioeconomic and behavioral survey of patients with difficult-to-control type 2 diabetes mellitus reveals an association between diabetic retinopathy and educational attainment.
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DOI：
10.2147/ppa.s116198
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发表时间：
2016
影响因子：
2.2
通讯作者：
Goto R
中科院分区：
文献类型：
--
作者：
Emoto N;Okajima F;Sugihara H;Goto R
我们最近报道，患者对风险的态度可能是糖尿病并发症进展的一个因素。一般来说，风险偏好与社会经济地位（SES）密切相关，其中包括年龄，性别，收入和教育程度等因素。我们的目的是确定SES和行为倾向对2型糖尿病（T2 DM）患者糖尿病并发症进展的影响。我们对238例在日本一家医院接受治疗的难以控制的T2 DM患者进行了一项调查，调查使用了改良的行为经济学问卷，其中包括与SES相关的问题。这些患者因代谢控制不佳或并发症不稳定而由全科医生或医院其他部门转诊。教育程度与<65岁患者的视网膜病变进展显著相关。高中文凭（12年教育）或更低的教育程度是一个重要的风险因素，但高中以上的教育程度（13-16年或更长时间）没有差异。行为倾向与并发症也有微弱的相关性，但没有教育程度那么多。个人收入水平和经济状况与视网膜病变水平无相关性。较低的教育程度是糖尿病视网膜病变的一个强有力的危险因素，它是独立的经济状况。提示认知功能在2型糖尿病视网膜病变的发生发展中起重要作用。
We have recently reported that the attitude of patients toward risk could be a factor in the progression of diabetic complications. In general, risk preference is closely related to socioeconomic status (SES), which includes factors such as age, sex, income, and educational attainment. We aimed to determine the effect of SES and behavioral propensity on the progress of diabetic complications in patients with type 2 diabetes mellitus (T2DM). We conducted a survey of 238 patients with difficult-to-control T2DM treated at a hospital in Japan using a modified behavioral economics questionnaire that included questions related to SES. The patients had been referred by general practitioners or other departments in the hospital because of poor metabolic control or unstable complications. Educational attainment was significantly associated with progression of retinopathy in patients <65 years of age. Educational attainment of a high school diploma (12 years of education) or lower was a significant risk factor, but there were no differences among levels of attainment beyond high school (13–16 years or more of education). Behavioral propensities were also weakly associated with complications, but not as much as educational attainment. Personal income level and economic status did not show an association with the retinopathy levels. Lower educational attainment is a strong risk factor for diabetic retinopathy, and it is independent of the economic status. The result suggests that cognitive function may play an important role in the progression of diabetic retinopathy in patients with T2DM.