The effects of economic status on metabolic control in type 2 diabetes mellitus at 10 metabolic management centers in China

Objective: This study investigated the association of economic status with metabolic index control in type 2 diabetes mellitus (T2DM) patients.Methods: In total, 37 454 T2DM patients from 10 National Metabolic Management Centers in China were recruited and categorized into two groups: a high-gross domestic product (GDP) group (n = 23 993) and a low-GDP group (n = 13 461). Sociodemographic characteristics, medical histories, and lifestyle factors were recorded. Logistic regression and interaction analysis were performed to evaluate the association of economic status and healthy lifestyle with metabolic control.Results: Compared to the low-GDP group, there were fewer patients withglycated hemoglobin (HbA1c) levels=7% in the high-GDP group. Fewerpatients with a high GDP had an abnormal metabolic state (HbA1c=7%,blood pressure [BP]=130/80 mm Hg, total cholesterol [TCH]=4.5 mmol/L orbody mass index [BMI]=24 kg/m2). The risks of developing HbA1c=7% (oddsratios [OR]=0.545 [95% CI: 0.515-0.577],p< .001), BP=130/80 mm Hg(OR=0.808 [95% CI: 0.770-0.849],p< .001), BMI=24 kg/m2(OR=0.840[95% CI: 0.799-0.884],p< .001), and an abnormal metabolic state (OR=0.533[95% CI: 0.444-0.636],p< .001) were significantly lower in the high-GDPgroup even after adjustment for confounding factors. Younger participants;those with a family history of diabetes, normal weight, and a physical activitylevel up to standard; and those who did not drink alcohol in the high-GDPgroup were predisposed to better glycemic levels.Conclusions: T2DM patients in economically developed regions had better metabolic control, especially glycemic control. A healthy lifestyle had an additive effect on achieving glycemic goals, even among high-GDP patients.