Impact of socio-economic status on Diabetes Mellitus knowledge and hemoglobin A1c control

OBJECTIVES: To assess the impact of socioeconomic status (SES) on Diabetes Mellitus (DM) knowledge and glycemic control among diabetic patients in Pakistan, considering the rising prevalence of DM and its associated economic burden. METHODS: This cross-sectional study was conducted over three months at a tertiary care hospital in 2020, involving 235 DM patients aged 20 to 75 years. The Diabetes Knowledge Questionnaire (DKQ) and modified Kuppuswamy index were employed to evaluate diabetes knowledge and SES, respectively. Glycemic control was assessed using hemoglobin A1c (HbA1c) levels, and statistical analyses were performed. RESULTS: Among 230 analyzed participants, 121 (52.4%) were females and 109 (47%) were males. Majority were type-2 DM (n=207; 90%). Mean age was 57.1 +/- 13.61 years, mean duration of DM was 14.07 +/- 9.54 years and mean Body Mass Index was 29.64 +/- 6.1 kg/m2. Majority of participants were from the upper middle (n=93; 40.4%) and lower-middle class (n=93; 40.4%); 20 (8.7%) were from lower class and 24 (10.4%) from upper class. The study revealed a strong impact of SES on diabetes knowledge (p=0.000*), with a gradual improvement from lower to upper classes. Similarly, SES significantly influenced glycemic control (p=0.005*), demonstrating a pattern of increased knowledge and improved glycemic control with higher socioeconomic status. CONCLUSION: This study underscores the significant relationship between socioeconomic status, diabetes knowledge, and glycemic control among Pakistani diabetic patients. Improved disease knowledge and better glycemic control were associated with higher socioeconomic classes, emphasizing the need for tailored educational interventions and healthcare strategies to mitigate the impact of diabetes in diverse socioeconomic groups.