Uncontrolled diabetes can lead to life-threatening situations where blood glucose levels can rapidly rise. For example, it can cause hyperglycemia leading to diabetic ketoacidosis or hyperglycemic hyperosmolar state. Uncontrolled diabetes can also cause blood glucose to fall (hypoglycemia). This may result in emergency hospitalization, coma, or death. We know that social factors (or “determinants”) can influence one’s ability to manage diabetes. Now researchers want to know if deprivation (a social determinant influenced by where a person lives) is linked to the acute, serious complications of uncontrolled diabetes.
Where you live and the risk of uncontrolled diabetes
Researchers studied a group of more than a million adults with diabetes. They found that, in this group, those who lived in areas of increasing socioeconomic deprivation (low-income areas) experienced significantly higher rates of emergency visits and hospitalizations for severe hypoglycemia and diabetic ketoacidosis or hyperglycemic hyperosmolar state. The strongest risk factors for both events were experiencing such events prior.
Structural racism and diabetes outcomes
Socioeconomically deprived counties may have fewer resources for diabetes care. For example, these counties may not have many doctors with availability or diabetes educators with expertise in diabetes management. There may also be fewer options to access better food and exercising. Another cause of this inequity are deeply rooted discriminatory housing policies that concentrate people from racial and ethnic minorities in neighborhoods with reduced access to education, employment, healthy food, and safe spaces for physical activity. These areas also tend to have higher pollution and environmental stress.
The findings suggest that county-level socioeconomic deprivation is a major risk factor for diabetes crises. This calls for interventions that target the structural barriers in low-income areas.