Association of social determinants of health and cardiovascular complications in type 2 diabetes in Colombia.

Abstract

Background: Social determinants of health are social and economic factors that influence health intervention outcomes. Type 2 diabetes is a highly prevalent disease, primarily affecting individuals in low-to-middle-income countries. However, the association between social determinants and cardiovascular complications in type 2 diabetes has not been widely studied.

Aim: To examine the relationship between social determinants of health and cardiovascular complications in individuals with type 2 diabetes.

Methods: We conducted a retrospective cohort study with an analytical component at a national-level referral hospital for military personnel in Bogota, Colombia. Patients treated at the diabetes clinic between September 2021 and December 2022 who met the inclusion criteria were included. A total of 583 patients participated in the study. We performed descriptive, bivariate, and binary logistic regression analyses, adjusting for confounding variables.

Results: Among the 583 patients included, urban residency [odds ratio (OR) = 3.05, 95% confidence interval (CI): 1.01-9.20] and a middle or high educational level (OR = 2.33, 95%CI: 1.14-4.72) were associated with an increased risk of coronary artery disease. Additionally, receiving diabetes education beyond that provided by the clinic (OR = 2.15, 95%CI: 1.14-4.05) and lack of access to spaces for physical activity (OR = 4.05, 95%CI: 1.31-12.5) were associated with a higher risk of diabetic nephropathy and cerebrovascular disease, respectively.

Conclusion: Programs for diabetes management should account for social determinants of health that contribute to cardiovascular complications and increased healthcare costs. Population-based studies are needed to guide targeted interventions and clarify causal relationships.