Modifiable Risk Factors and Socioeconomic Inequity in Diabetes: A Prospective Analysis in the UK Biobank.

Objective: To examine the association between overall socioeconomic status (SES) and incident diabetes, to estimate how much of the SES-diabetes association is explained by modifiable diabetes risk factors, and to assess whether the benefits of favorable risk factor profiles differ by SES. Methods: We analyzed 337,229 adults without diabetes at baseline from the UK Biobank. Overall SES was derived using latent class analysis based on income, occupation, and education. Modifiable diabetes risk factor scores were constructed across physiological, behavioral, environmental, and psychological domains. Cox proportional hazard models and additive hazard models were used to evaluate associations, mediation proportions, and interactions for incident diabetes. Results: for additive interaction ≤ 0.002). Conclusion: More than half of the excess diabetes risk associated with low SES can be explained by modifiable risk factors. Improving these factors may contribute to greater reduction in diabetes incidence among socioeconomically disadvantaged populations, supporting targeted diabetes prevention strategies to reduce socioeconomic disparities.