Study design and nature of diabetes may explain findings of Finnish study

Editor–Seppo V P Koskinen and colleagues show that the expected social class gradient in mortality is abolished in Finnish people with diabetes.1 They suggest that the most likely explanations are a lack of social class differences in health behaviours and an equitable health service. But it is difficult to see why Finnish people with diabetes adopt healthy lifestyles regardless of social class whereas non-diabetic Finnish people do not. Several studies indicate that the social class gradient …