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Blood sugar, social struggles: Biomarkers of socioeconomic, gender, and ethnic health disparities in type 2 diabetes care

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  • Consolazio, David
  • Russo, Antonio Giampiero

Abstract

Socioeconomic, gender, and ethnic disparities significantly affect Type 2 Diabetes Mellitus (T2DM) management, impacting healthcare access, treatment adherence, and outcomes. This study explores inequalities in glycaemic monitoring and testing in Milan (Northern Italy) using glycated haemoglobin data. Analysing administrative data from 56,795 T2DM patients aged 40 to 85, we assess the interplay of education, gender, and ethnicity in diabetes care. Findings show that all three dimensions impact T2DM care. A clear socioeconomic gradient exists among Italians. Males have higher testing rates and lower blood glucose levels than females, but inequalities are similar. Ethnic disparities are pronounced, with foreign-born individuals facing worse outcomes than Italians. Trends vary across groups, highlighting significant gender differences and sometimes reversed social gradients. These results underscore the need for targeted interventions to address structural inequalities in diabetes care and reduce health disparities. Integrating biomarkers into social epidemiology provides a framework for understanding how social determinants translate into biological outcomes, thereby guiding equitable healthcare policies.

Suggested Citation

  • Consolazio, David & Russo, Antonio Giampiero, 2025. "Blood sugar, social struggles: Biomarkers of socioeconomic, gender, and ethnic health disparities in type 2 diabetes care," Social Science & Medicine, Elsevier, vol. 383(C).
  • Handle: RePEc:eee:socmed:v:383:y:2025:i:c:s027795362500766x
    DOI: 10.1016/j.socscimed.2025.118435
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    1. Tashi Dendup & Xiaoqi Feng & Stephanie Clingan & Thomas Astell-Burt, 2018. "Environmental Risk Factors for Developing Type 2 Diabetes Mellitus: A Systematic Review," IJERPH, MDPI, vol. 15(1), pages 1-25, January.
    2. Krieger, N., 1992. "Overcoming the absence of socioeconomic data in medical records: Validation and application of a census-based methodology," American Journal of Public Health, American Public Health Association, vol. 82(5), pages 703-710.
    3. Bauer, Greta R., 2014. "Incorporating intersectionality theory into population health research methodology: Challenges and the potential to advance health equity," Social Science & Medicine, Elsevier, vol. 110(C), pages 10-17.
    4. Feyissa, Tesfaye Regassa & Wood, Sarah M. & Vakil, Krishna & MC Namara, Kevin & Coffee, Neil T. & Alsharrah, Saad & Daniel, Mark & Versace, Vincent L., 2024. "The built environment and its association with type 2 diabetes mellitus incidence: A systematic review and meta-analysis of longitudinal studies," Social Science & Medicine, Elsevier, vol. 361(C).
    5. Sahar Sidahmed & Siegfried Geyer & Johannes Beller, 2025. "Socioeconomic Inequalities in Diabetes Prevalence in Europe," SAGE Open, , vol. 15(1), pages 21582440251, January.
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