abstract: 'While socioeconomic inequalities in the prevalence and management of

  type 2 diabetes (T2D) are well established, little is known about

  whether inequalities exist in the prevalence and the temporal

  development of T2D comorbidities. Previous research points towards

  expansion of morbidity in T2D as depicted mainly by a rising trend of

  T2D comorbidities. Against this background, and using German claims

  data, this study aims to examine whether socioeconomic status (SES)

  inequalities exist in the rates and the temporal development of T2D

  comorbidities. Since previous research indicates varying risk levels for

  T2D prevalence in the population subgroups: working individuals,

  nonworking spouses and pensioners, the analyses are stratified by these

  three population subgroups. The study is done on a large population of

  statutory insured individuals with T2D in three time-periods between

  2005 and 2017. Predicted probabilities of three comorbidity groups and

  the number of comorbidities were estimated using logistic and ordinal

  regression analyses among different income, education and occupation

  groups. Interaction analyses were applied to examine whether potential

  SES inequalities changed over time. The study showed that neither the

  cross-sectional existence, nor the temporal development of T2D

  comorbidities differed significantly among SES groups, ruling out SES

  inequalities in the prevalence and the temporal development of T2D

  comorbidities in Germany. In men and women of all examined population

  subgroups, predicted probabilities for less severe cardiovascular (CVD)

  comorbidities, other vascular diseases and the number of comorbidities

  per individual rose significantly over time regardless of SES, but

  little if any change took place for more severe CVD comorbidities.

  Another important finding is that the population subgroup of nonworking

  spouses had markedly higher predicted probabilities for most of the

  examined outcomes compared to working individuals. The study indicates

  that the expansion of morbidity in T2D in Germany does not appear to be

  SES-dependent, and applies equally to different population subgroups.

  Yet, the study highlights that nonworking spouses are a susceptible

  population subgroup that needs to be focused upon when planning and

  implementing T2D management interventions.'
affiliation: 'Safieddine, B (Corresponding Author), Hannover Med Sch, Med Sociol Unit,
  Hannover, Germany.

  Safieddine, Batoul; Sperlich, Stefanie; Beller, Johannes; Geyer, Siegfried, Hannover
  Med Sch, Med Sociol Unit, Hannover, Germany.

  Lange, Karin, Hannover Med Sch, Med Psychol Unit, Hannover, Germany.'
author: Safieddine, Batoul and Sperlich, Stefanie and Beller, Johannes and Lange,
  Karin and Geyer, Siegfried
author-email: Safieddine.Batoul@mh-hannover.de
author_list:
- family: Safieddine
  given: Batoul
- family: Sperlich
  given: Stefanie
- family: Beller
  given: Johannes
- family: Lange
  given: Karin
- family: Geyer
  given: Siegfried
da: '2023-09-28'
doi: 10.1038/s41598-023-37951-y
files: []
issn: 2045-2322
journal: SCIENTIFIC REPORTS
keywords-plus: 'SELF-CARE BEHAVIORS; MULTIPLE ROLES; MELLITUS; PREVALENCE; COMPRESSION;

  DISPARITIES; CHILDHOOD; MORBIDITY; MORTALITY; EDUCATION'
language: English
month: JUL 5
number: '1'
number-of-cited-references: '57'
papis_id: 94a4ba442ea316c10e6f60c2119dcedf
ref: Safieddine2023socioeconomicinequal
times-cited: '0'
title: 'Socioeconomic inequalities in type 2 diabetes comorbidities in different population
  subgroups: trend analyses using German health insurance data'
type: article
unique-id: WOS:001024600400028
usage-count-last-180-days: '0'
usage-count-since-2013: '0'
volume: '13'
web-of-science-categories: Multidisciplinary Sciences
year: '2023'