UCL Discovery
UCL home » Library Services » Electronic resources » UCL Discovery

The impact of level of education on vascular events and mortality in patients with type 2 diabetes mellitus: Results from the ADVANCE study

Blomster, JI; Zoungas, S; Woodward, M; Neal, B; Harrap, S; Poulter, N; Marre, M; ... Hillis, GS; + view all (2017) The impact of level of education on vascular events and mortality in patients with type 2 diabetes mellitus: Results from the ADVANCE study. Diabetes Research and Clinical Practice , 127 pp. 212-217. 10.1016/j.diabres.2017.03.015. Green open access

[thumbnail of Williams ADVANCE education manuscript 5 Sept  2016.pdf]
Preview
Text
Williams ADVANCE education manuscript 5 Sept 2016.pdf - Accepted Version

Download (493kB) | Preview

Abstract

Aims The relationship between educational level and the risk of all-cause mortality is well established, whereas the association with vascular events in individuals with type 2 diabetes is not well described. Any association may reflect a link with common cardiovascular or lifestyle-based risk factors. Methods The relationships between the highest level of educational attainment and major cardiovascular events, microvascular complications and all-cause mortality were explored in a cohort of 11,140 individuals with type 2 diabetes. Completion of formal education before the age of 16 was categorized as a low level of education. Regional differences between Asia, East Europe and Established Market Economies were also assessed. Results During a median of 5 years of follow up, 1031 (9%) patients died, 1147 (10%) experienced a major cardiovascular event and 1136 (10%) a microvascular event. After adjustment for baseline characteristics and risk factors, individuals with lower education had an increased risk of cardiovascular events (hazard ratio (HR) 1.31, 95% CI 1.16–1.48, p < 0.0001), microvascular events (HR 1.23, 95% CI 1.08–1.39, p = 0.0013) and all-cause mortality (HR 1.34, 95% CI 1.18–1.52, p < 0.0001). In regional analyses the increased risk of studied outcomes associated with lower education was weakest in Established Market Economies and strongest in East Europe. Conclusions A low level of education is associated with an increased risk of vascular events and death in patients with type 2 diabetes, independently of common lifestyle associated cardiovascular risk factors. The effect size varies between geographical regions.

Type: Article
Title: The impact of level of education on vascular events and mortality in patients with type 2 diabetes mellitus: Results from the ADVANCE study
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.diabres.2017.03.015
Publisher version: https://doi.org/10.1016/j.diabres.2017.03.015
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Science & Technology, Life Sciences & Biomedicine, Endocrinology & Metabolism, Type 2 diabetes, Level of education, Cardiovascular events, Microvascular events, OF-THE-LITERATURE, CARDIOVASCULAR-DISEASE, SOCIOECONOMIC POSITION, PHYSICAL-ACTIVITY, INCOME COUNTRIES, RISK-FACTORS, US ADULTS, FOLLOW-UP, LIFE, HEALTH
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Population Science and Experimental Medicine
URI: https://discovery.ucl.ac.uk/id/eprint/10069263
Downloads since deposit
98Downloads
Download activity - last month
Download activity - last 12 months
Downloads by country - last 12 months

Archive Staff Only

View Item View Item