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2024

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The Lancet sub-journal, Huazhong University of Science and Technology Liu Gang team reveals the association between social determinants and health outcomes in patients with type 2 diabetes!

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Social determinants of health (SDHs) are major drivers of preventable health inequalities, and the association between SDHs and health outcomes in people with type 2 diabetes is unclear.

On August 3, 2024, Huazhong University of Science and Technology Liu Gang team inLancet Healthy LongevityPublished online entitled“Associations of social determinants of health with life expectancy and future health risks among individuals with type 2 diabetes: two nationwide cohort studies in the UK and USA”The research paper,The study exploresAssociations of social determinants of health with life expectancy and future health risks in people with type 2 diabetes.

The findings suggest that in adults with type 2 diabetes, the combination of adverse SDHs is associated with greater loss of life expectancy and a higher risk of developing adverse health outcomes in the future. These associations were similar in two national cohorts from different social backgrounds and were generally consistent across populations with different demographics, lifestyle, and clinical characteristics.Therefore, the evaluation of comprehensive SDHs in patients with type 2 diabetes may be a promising approach to incorporate diabetes care to identify socially vulnerable groups and reduce the burden of disease.

 

Social determinants of health are the conditions in which an individual is born, grows, lives, works and ages. There is growing recognition that the Sustainable Development Goals are upstream drivers of preventable health inequalities and that social determinants may be more important than health care or lifestyle choices in influencing health.The 2030 Healthy Population Goal also highlights the importance of the Sustainable Development Goals in reducing health disparities and proposes a framework that includes five areas to measure the overall Sustainable Development Goals, namely, financial status, access and quality of education, access and quality of health care, neighborhoods and the built environment, and social and community conditions.

The association between adverse SDHs and increased risk of type 2 diabetes is well established, and it is critical to understand the impact of SDHs across the entire history of type 2 diabetes; in particular, there is less of a SDHs advantage in patients with type 2 diabetes compared to the general population, and socioeconomic inequalities in type 2 diabetes prevalence are increasing in the UK and the US.

Years of life lost among adults with type 2 diabetes, participants in the moderate or poor SDH group versus participants in the good SDH group

Vulnerable SDHs are chronic psychosocial and environmental stressors that can induce chronic inflammation, and some individual vulnerable socioeconomic factors are associated with an increased risk of diabetic complications. However, different disadvantaged sustainable development countries often coexist and health-related pathways are interrelated; therefore, it is difficult to accurately quantify the impact of individual SDHs on diabetes-related outcomes.In addition, ignoring the synergistic effects of social risk factors will undoubtedly weaken efforts to identify socially vulnerable groups, thereby weakening the effectiveness of interventions.
In this study, less favourable SDHs were associated with a significant reduction in life expectancy in adults with type 2 diabetes and an increased risk of multiple future health outcomes. These associations are consistent across populations of different social backgrounds, different demographics, lifestyles, and clinical characteristics. In view of the existence of more adverse SDHs in patients with type 2 diabetes, and diabetes will further aggravate the adverse SDHs, so in the prevention and treatment of diabetes should be combined with SDHs as a basic principle to prevent a vicious circle.

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