Area-level socioeconomic status and incidence of abnormal glucose metabolism: the Australian Diabetes, Obesity and Lifestyle (AusDiab) study

Emily D. Williams, Dianna J. Magliano, Paul Z. Zimmet, Anne M Kavanagh, Christopher E Stevenson, Brian F. Oldenburg, Jonathan E. Shaw

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OBJECTIVEdTo examine the role of area-level socioeconomic status (SES) on the development
of abnormal glucose metabolism (AGM) using national, population-based data.
RESEARCH DESIGN AND METHODSdThe Australian Diabetes, Obesity and Lifestyle
(AusDiab) study is a national, population-based, longitudinal study of adults aged $25 years. A
sample of 4,572 people provided complete baseline (1999 to 2000) and 5-year follow-up (2004
to 2005) data relevant for these analyses. Incident AGM was assessed using fasting plasma
glucose and 2-h plasma glucose from oral glucose tolerance tests, and demographic, socioeconomic,
and behavioral data were collected by interview and questionnaire. Area SES was defined
using the Index of Relative Socioeconomic Disadvantage. Generalized linear mixed models were
used to examine the relationship between area SES and incident AGM, with adjustment for
covariates and correction for cluster design effects.
RESULTSdArea SES predicted the development of AGM, after adjustment for age, sex, and
individual SES. People living in areas with the most disadvantage were significantly more likely to
develop AGM, compared with those living in the least deprived areas (odds ratio 1.53; 95% CI
1.07–2.18). Health behaviors (in particular, physical activity) and central adiposity appeared to
partially mediate this relationship.
CONCLUSIONSdOur findings suggest that characteristics of the physical, social, and economic
aspects of local areas influence diabetes risk. Future research should focus on identifying
the aspects of local environment that are associated with diabetes risk and how they might be
Original languageEnglish
Pages (from-to)1455-1461
Number of pages7
JournalDiabetes Care
Issue number7
Publication statusPublished - Jul 2012

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