Individual and partner's level of occupation and the association with HbA1c 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., 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: Diabetes; Diabetes mellitus; Glucose; Hemoglobin; Socioeconomic factors
• ISSN: 0742-3071; 1464-5491
• DOI: 10.1111/dme.13422

Aims 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 HbA1c levels. We therefore examined the cross‐sectional association between individual and partner’s level of occupation on HbA1c levels in people with Type 2 diabetes in the Netherlands. Methods 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. Results 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 HbA1c 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 HbA1c 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. Conclusions Partner's occupational status provided additional information on the association between socio‐economic status and HbA1c 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. When studying socio‐economic status and diabetes‐related health outcomes, most studies focus on individual indicators of socio‐economic status. This is the first study to examine the association between individual and partner's level of occupation and HbA1c levels. We found that partner's occupational status provided significant additional information about the association between socio‐economic status and HbA1c levels in people with Type 2 diabetes: women seemed to have worse, while men seemed to have better HbA1c levels when they had a partner with a lower occupational level. This finding in men contradicts previous findings where low socio‐economic status has been associated with worse HbA1c levels.