Disability-related disparities in health outcomes among newly diagnosed diabetic patients: A retrospective cohort.

ABSTRACT

BACKGROUND: A distinct gap in the literature persists regarding the health outcome of individuals with Type 2 diabetes who also have disabilities. This study aimed to investigate potential disparities in events occurrence among diabetes patients across various disability stages. METHODS: We conducted a retrospective cohort study on patients newly diagnosed with diabetes in 2013 and 2014, aged ≥ 18 years, and followed them until December 2021, using data from the Korean National Health Insurance database. All-cause mortality and hospitalization for diabetes mellitus and cardio-cerebrovascular diseases (CVD) was assessed. RESULTS: The study included 26,085 patients, encompassing individuals without disabilities and those with physical, visual, hearing and speech, intellectual and developmental, and mental disabilities. After adjustment, individuals with disabilities had a higher risk of all-cause death (adjusted hazard ratio [aHR] 1.25, 95% CI 1.07-1.48) compared to those without disabilities. In particular, severe disabilities and hearing and speech disabilities showed significantly higher risks of all-cause death (aHR 1.40, 95% CI 1.06-1.85 and aHR 1.58, 95% CI 1.17-2.15, respectively), with marginal significance for mild disabilities (aHR 1.20, 95% CI 0.99-1.45) and mental disorders (aHR 1.92, 95% CI 0.98-3.73). Patients with disabilities also had significantly increased risks of CVD-related first admissions (aHR 1.30, 95% CI 1.07-1.56) and diabetes-related first admissions (aHR 1.31, 95% CI 1.20-1.43) compared to those without disabilities. CONCLUSIONS: This study underscores the urgent need for public health policies to prioritize individuals with disabilities and diabetes, addressing the disparities in health outcome.