Low income linked to higher mortality risk in young adults with diabetes

The research team of Professor Sin Gon Kim and Professor Nam Hoon Kim of department of internal medicine (Endocrinology and Metabolism) of Korea University Anam Hospital, and Professor Ji Yoon Kim of Samsung Medical Center confirmed that young adults with T2D with low income have 3 times higher mortality risk than those with high income.

The number of young people with diabetes is increasing globally. In South Korea, the number of incidence and prevalence of young people with diabetes under the age of 40 is also increasing. Approximately more than 300,000 people are suffering from diabetes currently.

Studies have shown that the social and economic environment of diabetic patients influences the risk of complications or death, but no research has been conducted on whether income level affects young diabetic patients.

The research team utilized the Korean National Health Insurance Service (NHIS) database between 2008 and 2013 and analyzed approximately 600,000 T2D patients aged 20 to 79 years. This research categorized participants' income into 3 levels (low, middle, and high) and investigated the relations with mortality.

As a result, within the T2D group under the age of 40, patients in the low-income level had 2.88 times as higher mortality risks than the high-income level group. The same analysis was conducted for the T2D patients over the age of 60, and the mortality risk was 1.26 times higher. This implies that the T2D patient group under the age of 40 have much higher income-related mortality risk than the T2D patient group over the age of 60.

In addition, T2D patients with low income have 2.66 times higher cardiovascular mortality, and 1.41 times higher risk of developing atherosclerotic cardiovascular disease (ASCVD) than those with high income.

Young adults with diabetes have difficulty in controlling blood glucose level, and the tendencies in developing complications earlier. Other than medical perspectives, it seems that socioeconomic environment greatly affect the health outcomes of young people with diabetes. There is a need for efforts to resolve health disparities from various perspectives such as expanding the support for the young diabetics at the national and policy levels."

Professor Nam Hoon Kim, Korea University Anam Hospital 

The study 'Income-Related Disparities in Mortality Among Young Adults With Type 2 Diabetes' was published in JAMA Network Open in November.