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

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.