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Diabetics from deprived areas more likely to be admitted

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People with diabetes from deprived backgrounds in England are twice as likely to end up in hospital with a heart attack or stroke than those who are better off, according to new research.

The nationwide study by Imperial College London suggests a stark difference between diabetics from different socioeconomic groups when it comes to life-threatening cardiovascular problems despite improvements in outcomes in the general population over the past decade.

“Our findings indicate profound socioeconomic differences in outcomes”

Eszter Vamos

Researchers identified all patients with diabetes aged 45 and over admitted to hospital in England for major cardiovascular events in the 10 years from 2004-05 to 2014-15.

They went on to work out admission rates for each year according to level of deprivation and found these rose steadily as deprivation levels increased.

People with diabetes from the most deprived 20% of the population were around twice as likely to be admitted to hospital with a heart attack, stroke, percutaneous coronary intervention, or coronary artery bypass graft compared to the most affluent groups.

However, the results suggest the gulf may be narrowing for some conditions. While the difference in admission rates between rich and poor remained roughly the same for heart attacks over the study period, the gap reduced for stroke, percutaneous coronary intervention and coronary bypass graft.

Meanwhile, the analysis found no difference in inpatient mortality rates between the least and most deprived groups with hospital death rates falling for all conditions apart from percutaneous coronary intervention – formerly referred to as angioplasty with a stent.

“These findings highlight the need for strengthened efforts to prevent and reduce cardiovascular risk”

Eszter Vamos

Research lead Dr Eszter Vamos said the study emphasised the need to target efforts to prevent and reduce cardiovascular disease in deprived areas.

“Our findings indicate profound socioeconomic differences in outcomes, with cardiovascular disease among people with diabetes concentrated in those from socioeconomically disadvantaged backgrounds,” she said.

“These findings highlight the need for strengthened efforts to prevent and reduce cardiovascular risk in populations living in more deprived areas,” she added.

The findings were presented this week at the annual meeting of the European Association for the Study of Diabetes in Berlin. They are also published in the American Journal of Medicine.

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