Social deprivation and diabetic kidney disease: A European view,Journal of Diabetes Investigation

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Social deprivation and diabetic kidney disease: A European view
Journal of Diabetes Investigation ( IF 3.1 ) Pub Date : 2024-01-27 , DOI: 10.1111/jdi.14156
Caoimhe Casey _{1,

2} , Claire M Buckley ₂ , Patricia M Kearney ₂ , Matthew D Griffin _{3,

4} , Sean F Dinneen _{1,

5} , Tomás P Griffin _{1,

5}

Affiliation

There is a large body of literature demonstrating a social gradient in health and increasing evidence of an association between social deprivation and diabetes complications. Diabetic kidney disease (DKD) increases mortality in people with diabetes. Socioeconomic deprivation is increasingly recognized as a modifier of risk factors for kidney disease but also an independent risk factor itself for kidney disease. This may not be truly appreciated by clinicians and warrants further attention and exploration. In this review we explore the literature to date from Europe on the relationship between social deprivation and DKD. The majority of the studies showed at least an association with microalbuminuria, an early marker of DKD, while many showed an association with overt nephropathy. This was seen across many countries in Europe using a variety of different measures of deprivation. We reviewed and considered the mechanisms by which deprivation may lead to DKD. Health related behaviors such as smoking and suboptimal control of risk factors such as hypertension, hyperglycemia and elevated body mass index (BMI) accounts for some but not all of the association. Poorer access to healthcare, health literacy, and stress are also discussed as potential mediators of the association. Addressing deprivation is difficult but starting points include targeted interventions for people living in deprived circumstances, equitable roll out of diabetes technology, and flexible outpatient clinic arrangements including virtual and community-based care.

中文翻译：

社会剥夺和糖尿病肾病：欧洲的观点

有大量文献证明了健康方面的社会梯度，并且越来越多的证据表明社会剥夺与糖尿病并发症之间存在关联。糖尿病肾病 (DKD) 会增加糖尿病患者的死亡率。社会经济剥夺越来越被认为是肾脏疾病危险因素的调节因素，但本身也是肾脏疾病的独立危险因素。这可能并没有被临床医生真正认识到，值得进一步关注和探索。在这篇综述中，我们探讨了迄今为止欧洲有关社会剥夺与 DKD 之间关系的文献。大多数研究表明至少与微量白蛋白尿（DKD 的早期标志）有关，而许多研究表明与明显的肾病有关。欧洲许多国家都采取了各种不同的剥夺措施，都出现了这种情况。我们回顾并考虑了剥夺可能导致 DKD 的机制。吸烟等健康相关行为以及对高血压、高血糖和体重指数 (BMI) 升高等危险因素控制不佳是部分关联的原因，但不是全部关联。获得医疗保健的机会较少、健康素养和压力也被认为是该关联的潜在中介因素。解决贫困问题很困难，但起点包括对生活在贫困环境中的人们进行有针对性的干预、公平推广糖尿病技术以及灵活的门诊安排，包括虚拟和社区护理。

更新日期：2024-01-27

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