Country of birth, socioeconomic factors, and risk factor control in patients with type 2 diabetes: a Swedish study from 25 primary health‐care centres

BACKGROUND: Few large-scale studies have examined the association between sociodemographic factors and the probability of reaching the recommended levels of haemoglobin A1c (HbA(1c)) and blood lipids in patients with type 2 diabetes. The aim was to investigate whether sociodemographic characteristics of patients with type 2 diabetes affected the odds that they would reach recommended levels of blood lipids and HbA(1c). METHODS: This study included 2912 men and 2136 women, in the age group of 35-74, with diagnosed type 2 diabetes from 25 primary health-care centres in Stockholm, Sweden. National population registers were linked to clinical data from electronic records and logistic regression was used to estimate odds ratios. RESULTS: Less than half of the men and women with diabetes reached the recommended levels of HbA(1c). Even fewer reached the recommended levels for total cholesterol and low-density lipoprotein cholesterol. The gender differences favoured women, for HbA(1c) and men, for blood lipids. Individuals with the lowest income levels were less likely to reach the recommended level of HbA(1c). Country of birth showed that immigrants from Middle Eastern countries and other countries had lower odds of reaching the recommended levels of HbA(1c). CONCLUSION: This study confirmed that risk factor control among patients with type 2 diabetes treated in primary health care is inadequate and that sociodemographic factors were associated with metabolic control. Future studies could include new strategies for the control of modifiable risk factors in patients with type 2 diabetes.