AIMS/HYPOTHESIS: To identify the impact of socioeconomic status on incident impaired glucose metabolism and type 2 diabetes and to investigate the mediating role of health behaviours on this relationship using national, population-based data. METHODS: The Australian Diabetes Obesity and Lifestyle (AusDiab) Study is a national, population-based, longitudinal study of adults aged 25 years and above. A total sample of 4,405 people provided complete baseline (1999-2000) and 5 year follow-up (2004-2005) data relevant for these analyses. Fasting plasma glucose and 2 h plasma glucose were obtained from an OGTT, and demographic, socioeconomic and behavioural data were collected by interview and questionnaire. Multinomial logistic regression examined the role of socioeconomic position in the development of diabetes and mediation analyses tested the contribution of health behaviours in this relationship. RESULTS: Highest level of education was a stronger predictor of incident impaired glucose tolerance and type 2 diabetes (p = 0.002), compared with household income (p = 0.103), and occupational grade (p = 0.202). Education remained a significant independent predictor of diabetes in fully adjusted models. However, the relationship was attenuated by the health behaviours (smoking and physical activity). Mediation analyses indicated that these behaviours were partial mediators (explaining 27%) of the socioeconomic status-diabetes relationship. CONCLUSION/ INTERPRETATION: Smoking and physical activity partly mediate the relationship between low education and type 2 diabetes. Identification of these modifiable behavioural mediators should facilitate the development of effective health promotion campaigns to target those at high risk of developing type 2 diabetes.
AIMS/HYPOTHESIS: To identify the impact of socioeconomic status on incident impaired glucose metabolism and type 2 diabetes and to investigate the mediating role of health behaviours on this relationship using national, population-based data. METHODS: The Australian Diabetes Obesity and Lifestyle (AusDiab) Study is a national, population-based, longitudinal study of adults aged 25 years and above. A total sample of 4,405 people provided complete baseline (1999-2000) and 5 year follow-up (2004-2005) data relevant for these analyses. Fasting plasma glucose and 2 h plasma glucose were obtained from an OGTT, and demographic, socioeconomic and behavioural data were collected by interview and questionnaire. Multinomial logistic regression examined the role of socioeconomic position in the development of diabetes and mediation analyses tested the contribution of health behaviours in this relationship. RESULTS: Highest level of education was a stronger predictor of incident impaired glucose tolerance and type 2 diabetes (p = 0.002), compared with household income (p = 0.103), and occupational grade (p = 0.202). Education remained a significant independent predictor of diabetes in fully adjusted models. However, the relationship was attenuated by the health behaviours (smoking and physical activity). Mediation analyses indicated that these behaviours were partial mediators (explaining 27%) of the socioeconomic status-diabetes relationship. CONCLUSION/ INTERPRETATION: Smoking and physical activity partly mediate the relationship between low education and type 2 diabetes. Identification of these modifiable behavioural mediators should facilitate the development of effective health promotion campaigns to target those at high risk of developing type 2 diabetes.
Authors: David W Dunstan; Paul Z Zimmet; Timothy A Welborn; Maximilian P De Courten; Adrian J Cameron; Richard A Sicree; Terry Dwyer; Stephen Colagiuri; Damien Jolley; Matthew Knuiman; Robert Atkins; Jonathan E Shaw Journal: Diabetes Care Date: 2002-05 Impact factor: 19.112
Authors: Esther M Briganti; Jonathan E Shaw; Steven J Chadban; Paul Z Zimmet; Timothy A Welborn; John J McNeil; Robert C Atkins Journal: Med J Aust Date: 2003-08-04 Impact factor: 7.738
Authors: Emilie E Agardh; Anders Ahlbom; Tomas Andersson; Suad Efendic; Valdemar Grill; Johan Hallqvist; Claes-Göran Ostenson Journal: Diabetes Care Date: 2004-03 Impact factor: 19.112
Authors: Jacqueline A Seiglie; Maja-Emilia Marcus; Cara Ebert; Nikolaos Prodromidis; Pascal Geldsetzer; Michaela Theilmann; Kokou Agoudavi; Glennis Andall-Brereton; Krishna K Aryal; Brice Wilfried Bicaba; Pascal Bovet; Garry Brian; Maria Dorobantu; Gladwell Gathecha; Mongal Singh Gurung; David Guwatudde; Mohamed Msaidié; Corine Houehanou; Dismand Houinato; Jutta Mari Adelin Jorgensen; Gibson B Kagaruki; Khem B Karki; Demetre Labadarios; Joao S Martins; Mary T Mayige; Roy Wong-McClure; Joseph Kibachio Mwangi; Omar Mwalim; Bolormaa Norov; Sarah Quesnel-Crooks; Bahendeka K Silver; Lela Sturua; Lindiwe Tsabedze; Chea Stanford Wesseh; Andrew Stokes; Rifat Atun; Justine I Davies; Sebastian Vollmer; Till W Bärnighausen; Lindsay M Jaacks; James B Meigs; Deborah J Wexler; Jennifer Manne-Goehler Journal: Diabetes Care Date: 2020-02-12 Impact factor: 19.112
Authors: E Gearon; K Backholer; C Stevenson; D J Magliano; C Keating; K Ball; A Beauchamp; A Peeters Journal: Int J Obes (Lond) Date: 2015-03-16 Impact factor: 5.095
Authors: Emily D Williams; Dianna J Magliano; Paul Z Zimmet; Anne M Kavanagh; Christopher E Stevenson; Brian F Oldenburg; Jonathan E Shaw Journal: Diabetes Care Date: 2012-05-22 Impact factor: 19.112
Authors: Christie Y Jeon; Mary N Haan; Caroline Cheng; Erin R Clayton; Elizabeth R Mayeda; Joshua W Miller; Allison E Aiello Journal: Diabetes Care Date: 2012-01-25 Impact factor: 19.112
Authors: Stephanie T Broyles; Amanda E Staiano; Kathryn T Drazba; Alok K Gupta; Melinda Sothern; Peter T Katzmarzyk Journal: PLoS One Date: 2012-09-25 Impact factor: 3.240
Authors: Silvia Stringhini; Adam G Tabak; Tasnime N Akbaraly; Séverine Sabia; Martin J Shipley; Michael G Marmot; Eric J Brunner; G David Batty; Pascal Bovet; Mika Kivimäki Journal: BMJ Date: 2012-08-21