Risk factors for diabetes in menBMJ 1995; 311 doi: https://doi.org/10.1136/bmj.311.6998.188 (Published 15 July 1995) Cite this as: BMJ 1995;311:188
- Vincent Connolly,
- William Kelly
- Senior registrar Consultant physician Diabetes Care Centre, Middlesbrough General Hospital, Middlesbrough TS5 5AZ
Risk factors are closely linked with socioeconomic status
EDITOR,--The association between risk factors and diabetes described by Eric B Rimm and colleagues1 is unlikely to be simple, and both smoking and obesity are linked to socioeconomic status. Our studies on diabetic subjects in Glasgow2 and Middlesbrough3 have shown that low socioeconomic status is associated with a high prevalence of smoking and higher body mass indices. The increased smoking and obesity in low socioeconomic groups remain unexplained, although intrauterine, genetic, and psychological factors have been proposed. Ivan J Perry and colleagues include socioeconomic status in their study by including manual occupation as a variable, but this alone did not predict diabetes.4
We suggest that measures of socioeconomic status based on areas5 6 could be used, combined with measures of smoking, obesity, and physical activity. We are performing a study to investigate these factors. It may then be possible to identify high risk areas and populations in which screening for diabetes will be beneficial. Because of the suggestion that diabetes is undiagnosed in up to 1% of the population and the difficulties associated with screening, perhaps resources should be focused on areas of low socioeconomic status in an effort to uncover the hidden burden of diabetes.