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dc.contributor.authorSebastian-Valles, Fernando
dc.contributor.authorMartínez-Alfonso, Julia
dc.contributor.authorArranz Martin, Jose Alfonso
dc.contributor.authorJiménez-Díaz, Jessica
dc.contributor.authorHernando Alday, Iñigo
dc.contributor.authorNavas-Moreno, Victor
dc.contributor.authorJoya, Teresa Armenta
dc.contributor.authorFandiño García, Maria del Mar
dc.contributor.authorRomán Gómez, Gisela Liz
dc.contributor.authorGarai Hierro, Jon
dc.contributor.authorLander Lobariñas, Luis Eduardo
dc.contributor.authorMartínez de Icaya, Purificación
dc.contributor.authorSampedro-Nuñez, Miguel Antonio
dc.contributor.authorMartínez-Vizcaíno, Vicente
dc.contributor.authorMarazuela, Mónica
dc.date.accessioned2024-04-09T22:50:42Z
dc.date.available2024-04-09T22:50:42Z
dc.date.issued2024
dc.identifier10.1186/s12916-024-03254-w
dc.identifier.issn17417015
dc.identifier.urihttps://hdl.handle.net/20.500.12728/10319
dc.description.abstractBackground: This study investigates the association between socioeconomic status (SES) and glycemic control in individuals with type 1 diabetes (T1D) using flash glucose monitoring (FGM) devices within a public health system where these technologies are freely available and utilized according to recommended guidelines. Methods: A follow-up study of 1060 adults (mean age 47.4 ± 15.0 years, 49.0% women) with T1D, receiving care at three Spanish university hospitals that regularly employ the FGM system. SES was assessed using the Spanish Deprivation Index and the average annual net income per person. Glycemic data were collected over a 14-day follow-up period, including baseline glycated hemoglobin (HbA1c) levels prior to sensor placement, the last available HbA1c levels, and FGM-derived glucose metrics. Individuals with sensor usage time < 70% were excluded. Chronic micro and macrovascular complications related to diabetes were documented. Regression models, adjusted for clinical variables, were employed to determine the impact of SES on optimal sensor control (defined as time in range (TIR) ≥ 70% with time below range < 4%) and disease complications. Results: The average follow-up was of 2 years. The mean TIR and the percentage of individuals with optimal control were higher in individuals in the highest SES quartile (64.9% ± 17.8% and 27.9%, respectively) compared to those in the lowest SES quartile (57.8 ± 17.4% and 12.1%) (p < 0.001). Regression models showed a higher risk of suboptimal control (OR 2.27, p < 0.001) and ischemic heart disease and/or stroke (OR 3.59, p = 0.005) in the lowest SES quartile. No association was observed between SES and the risk of diabetic nephropathy and retinopathy. FGM system improved HbA1c levels across all SES quartiles. Although individuals in the highest SES quartile still achieved a significantly lower value at the end of the follow-up 55 mmol/mol (7.2%) compared to those in the lowest SES quartile 60 mmol/mol (7.6%) (p < 0.001), the significant disparities in this parameter between the various SES groups were significantly reduced after FGM technology use. Conclusions: Socioeconomic status plays a significant role in glycemic control and complications in individuals with T1D, extending beyond access to technology and its proper utilization. The free utilization of FGM technology helps alleviate the impact of social inequalities on glycemic control. © 2024, The Author(s).es_ES
dc.description.sponsorshipAdela Valles Fernández Jose María Galván Román; Manuel Díaz Olalla; Manuel Gómez Gutiérrez; Comunidad de Madrid; Federación Española de Enfermedades Raras, FEDER; Instituto de Salud Carlos III, ISCIII, (P2022/BMD7379)es_ES
dc.language.isoenes_ES
dc.publisherBioMed Central Ltdes_ES
dc.subjectContinuous glucose monitoringes_ES
dc.subjectDiabetes technologyes_ES
dc.subjectHealth inequalitieses_ES
dc.subjectSocioeconomic deprivationes_ES
dc.subjectSocioeconomic statuses_ES
dc.subjectT1Des_ES
dc.titleImpact of socioeconomic status on chronic control and complications of type 1 diabetes mellitus in users of glucose flash systems: a follow-up studyes_ES
dc.typeArticlees_ES


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