181316 Determinants of Early vs. Late Diagnosis of Diabetes in Newfoundland and Labrador, Canada

Sunday, October 26, 2008

Madonna Murphy, MSc, PhD (c) , Research and Evaluation Department, Newfoundland and Labrador Centre for Health Information, St. John's, NF, Canada
Kayla Collins, MSc, PhD (c) , Research and Evaluation Department, Newfoundland and Labrador Centre for Health Information, St. John's, NF, Canada
Don MacDonald, MSc, PhD (c) , Research and Evaluation Department, Newfoundland and Labrador Centre for Health Information, St. John's, NF, Canada
Reza Alaghehbandan, MD , Research and Evaluation Department, Newfoundland and Labrador Centre for Health Information, St. John's, NF, Canada
Ann Colbourne, MD, FRCPC, FACP , Memorial University/Eastern Health/Department of Health & Community Services, St. John's, NF, Canada
Jeff Dowden, MAS , Research and Evaluation Department, Newfoundland and Labrador Centre for Health Information, St. John's, NF, Canada
Khokan C. Sikdar, MSc, MAS, PhD (c) , Research and Evaluation Department, Newfoundland and Labrador Centre for Health Information, St. John's, NF, Canada
Objective: To examine determinants of early vs. late diagnosis of type-2 diabetes in Newfoundland and Labrador (NL), Canada.

Methods: Using a cross-sectional design, administrative health databases (National Diabetes Surveillance System (NDSS), provincial hospital separation database, fee-for-service physician claims) and health surveys (Canadian Community Health Surveys 2001, 2003 and 2005) were linked via health care number to identify patients with diabetes. The sample included individuals aged 25+ years identified as an incident case of diabetes by the NDSS. Diabetes patients were classified into two groups, ‘early' or ‘late' diagnosis based on a case definition developed for the study based on when various co-morbidities developed. Demographic, socioeconomic, lifestyle factors were compared between the two groups to assess potential determinants of early vs. late diagnosis of type-2 diabetes.

Results: Diabetes patients diagnosed late were more likely to be 65 years of age or older at the time of diagnosis compared to those who were diagnosed early (50.5% vs. 38.5%, P<0.05). Late diagnosed diabetes patients were more likely to have a low level of income compared to early diagnosed patients (51.2% vs. 33.2%, P<0.05). Diabetes patients diagnosed early were more likely to consume alcohol compared to late diagnosed patients (61.7% vs. 50.0%, P<0.05). Early diagnosed diabetes patients were more likely to have a regular medical doctor compared to late diagnosed patients (94.8% vs. 87.4%, P<0.05).

Conclusion: This study highlights determinants of early vs. late diagnosis of type-2 diabetes in NL. These findings can support public health decision-making related to diabetes prevention and management.

Learning Objectives:
Following this session, participants will be able to 1. Describe the differences in diabetes patients who are diagnosed early and those that are diagnosed late. 2. Realize the need for continued and enhanced prevention programs to reduce late diagnosis of diabetes.

Keywords: Diabetes, Chronic Diseases

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been employed as an epidemiologist with the Newfoundland and Labrador Centre for Health Information for the past 3 years. This role has allowed me to develop my applied health research skills. Also, I am a PhD candidate at Memorial University of Newfoundland in Community Health. This program has also provided me with an opportunity to conduct applied health research in relation to diabetes epidemiology.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

See more of: Cardiovascular Disease Epidemiology Poster Session
See more of: Epidemiology