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Impact of Socioeconomic Status on the Prevalence of Complications in Type 2 Diabetes in Indian Population: A Systematic Review

      Objectives

      India as said to be the diabetic capital of the world. This systematic review aims to determine the association between socioeconomic status (SES) and complications associated with Type 2 Diabetes Mellitus.

      Methods

      Literature search was conducted in databases such as PubMed, EMBASE and the Cochrane library without any restrictions. References of the included studies were screened for additional studies. We included observational studies focussing on association between SES and T2DM patients. The quality of the studies was assessed using the Newcastle-Ottawa scale. Two authors independently performed the study selection, data extraction and the quality assessment process. A third author reviewed the output and adjudicated discussions in case of disagreement.

      Results

      A total of 440 studies were retrieved by the databases search, of which only 4 studies were included in the final review. One study reported that T2DM population with SES groups were at high risk for developing visual impairment (odds ratio [OR] 2.91; 95% confidence interval [CI] 1.24-6.85). Similarly, another study showed high prevalence of diabetes peripheral neuropathy in lower SES (48.4%) group compared to upper SES group (10.2%). A positive association of cataract was observed in low SES group compared to higher SES group (OR 1.67; 95% CI 1.10-2.54; one study). In contrast to these findings, one study reported no significant differences between SES groups in the occurrence of any form of micro-vascular complications.

      Conclusions

      The present review found very limited evidence regarding the association between socioeconomic status and diabetes complications. The available evidence suggest that diabetic peripheral neuropathy and eye related complications are high in low SES population, suggesting the need for educating patients with low SES to prevent long term complications in Indian T2DM patients. More observational studies are required to be conducted in the future in this context.