Individual and partner's level of occupation and the association with HbA 1c levels in people with Type 2 diabetes mellitus: the Dutch Diabetes Pearl cohort

• Published in: Diabetic medicine 2017-11, Vol.34 (11), p.1623-1628
• Main Authors: Rutte, A, Rauh, S P, Schram, M T, Nijpels, G, DeVries, J H, Holleman, F, Pijl, H, Dekkers, O M, Özcan, B, Sijbrands, E J G, Tack, C J, Abbink, E J, de Valk, H W, Silvius, B, Wolffenbuttel, B H R, Stehouwer, C D A, Schaper, N C, Dekker, J M, Beulens, J W, Elders, P J M, Rutters, F
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Blood Glucose - analysis; Cohort Studies; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - epidemiology; Female; Glycated Hemoglobin A - analysis; Humans; Male; Middle Aged; Netherlands - epidemiology; Occupations - statistics & numerical data; Social Class; Social Support; Spouses - statistics & numerical data; Young Adult
• ISSN: 0742-3071; 1464-5491
• DOI: 10.1111/dme.13422

Individual indicators of socio-economic status have been associated with glycaemic control in people with Type 2 diabetes, but little is known about the association between partner's socio-economic status and HbA levels. We therefore examined the cross-sectional association between individual and partner's level of occupation on HbA levels in people with Type 2 diabetes in the Netherlands. We included people with Type 2 diabetes with a partner who were treated in primary, secondary and tertiary care in the Diabetes Pearl cohort. Occupational level was classified according to International Standard Classification of Occupations (ISCO)-08 skill levels. Linear regression analyses were performed stratified for sex, and corrected for age, recruitment centre and diabetes medication. In total, 3257 participants (59.8% men, mean 62.2±9.4 years) were included. For men, having a partner with an intermediate level of occupation was associated with lower HbA levels [e.g. ISCO level 3: -2 mmol/mol (95% CI -4;-1) or -0.2% (95% CI -0.4;-0.1)], compared with having a partner of the highest occupational level (ISCO level 4). In women, having an unemployed partner was associated with higher HbA levels [14 mmol/mol (95% CI 6; 22) or 1.3% (95% CI 0.6; 2.0)], compared with having a partner of the highest occupational level. Partner's occupational status provided additional information on the association between socio-economic status and HbA levels in people with Type 2 diabetes. Women seemed to benefit from a partner with a higher occupational status, while men seemed to benefit from a partner with a lower status. Because of the cross-sectional nature of the present study, more research is necessary to explore this association.