Evidence mapPaperPMID 40675646Full record

ArticleBMJ open2025

Social inequalities in diabetes incidence and quality of care: results from a cohort study in the Lazio region, Italy.

Angelo Nardi, Chiara Sorge, Silvia Cascini, Marina Davoli, Nera Agabiti, Teresa Dalla Zuanna, Giulia Cesaroni

Abstract read
In one paragraph

Article in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Angelo NardiHealth District 2, Local Health Authority Rome 1, Rome, Italy angelo.nardi@aslroma1.it.ORCID http://orcid.org/0000-0002-2537-9964
Chiara SorgeDepartment of Epidemiology-Regional Health Service, Local Health Authority Rome 1, Rome, Italy.ORCID http://orcid.org/0000-0002-7277-5900
Silvia CasciniDepartment of Epidemiology-Regional Health Service, Local Health Authority Rome 1, Rome, Italy.
Marina DavoliDepartment of Epidemiology-Regional Health Service, Local Health Authority Rome 1, Rome, Italy.
Nera AgabitiDepartment of Epidemiology-Regional Health Service, Local Health Authority Rome 1, Rome, Italy.ORCID http://orcid.org/0000-0003-3385-1197
Teresa Dalla ZuannaEuganea Local Unit of Health and Social Services 6, Padova, Italy.
Giulia CesaroniDepartment of Epidemiology-Regional Health Service, Local Health Authority Rome 1, Rome, Italy.ORCID http://orcid.org/0000-0001-7361-9072

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesSocioeconomic disparities in diabetes incidence vary across countries and geographical areas. In addition, once diabetes is diagnosed, further disparities can arise during the whole care process. This study aims to evaluate disparities in incidence and glycated haemoglobin (HbA1c) testing in Central Italy.

designCohort study.

settingLazio region, Italy.

participantsWe used the Lazio Region Longitudinal Study, which is the 2011 census cohort of all residents followed from January 2012 to December 2022. We selected 2 912 539 diabetes-free individuals aged 35-90 years at baseline (54% women). We used educational attainment as the indicator of socioeconomic position and place of residence and birth citizenship as possible confounders.

main outcome measuresWe identified incident cases of type 2 diabetes from 2012 to 2022 using health databases. We searched for an HbA1c test in the 13 months following case identification. We used Cox proportional hazard models and logistic regression models stratified by sex to study disparities in diabetes incidence and HbA1c testing, respectively.

resultsWe identified 192 268 new cases (49% women). We found incidence disparities, with the lowest educational level showing a risk that is twice or more than the highest in men (HR 2.03, 95% CI 1.98 to 2.08) and women (HR 2.32, 95% CI 2.26 to 2.39), respectively. Disparities were less pronounced in the older groups. Fewer than 60% of individuals across all educational levels had at least one HbA1c test. Compared with those with university degrees, people with the lowest education showed a higher probability of being tested for HbA1c in men (OR 1.56, 95% CI 1.48 to 1.64) and women (OR 1.62, 95% CI 1.53 to 1.72).

conclusionsWe found inequalities in diabetes incidence in both sexes, mainly among younger groups. The highly educated were less likely to be tested for HbA1c, although different private sector utilisation could have influenced this result.

Indexed as

Diabetes Mellitus, Type 2Healthcare DisparitiesQuality of Health CareAdultAgedAged, 80 and overCohort StudiesEducational StatusFemaleGlycated HemoglobinHumansIncidenceItalyLongitudinal StudiesMaleMiddle AgedGlycated Hemoglobinhemoglobin A1c protein, humanDiabetes Mellitus, Type 2EPIDEMIOLOGYHealth Equity

Identifiers

PMID40675646
PMCPMC12273125

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.