Introduction: Despite clinical advancements, individuals with type 1 diabetes mellitus (T1DM) diagnosed in childhood may face long-term socioeconomic and health challenges. However, population-based evidence on these outcomes remains scarce. Objectives: To assess disparities in socioeconomic conditions, health status, and daily functioning among adults with T1DM diagnosed before age 18, compared to matched controls, using nationally representative data. Methods: Data were drawn from the Italian PASSI surveillance system (Italian Behavioral Risk Factor Surveillance System, 2011–2018, 2023). Adults aged 18–50 who self-reported a physician-diagnosed diabetes before the age of 18 and were currently receiving insulin therapy were classified as having T1DM cases. Each case was matched by age and sex to two healthy controls. Outcomes included marital status, employment, economic hardship, self-rated health, and number of days with physical, mental, or activity impairment. Logistic regression was used to estimate associations, adjusting for age and sex. Results: Out of 319,801 individuals aged 18-69, 331 individuals (1‰) were classified as having T1DM and were matched with 662 controls. T1DM was associated with higher odds of unemployment (aOR: 1.57 [1.20–2.07]), severe financial difficulty (aOR: 1.81 [1.05–3.13]), and poor self-reported health (aOR: 6.64 [2.53–17.43]). Individuals with T1DM were more likely to report ≥14 days/month of physical (aOR: 2.95 [1.54–5.65]) or mental (aOR: 2.16 [1.46–3.19]) impairment, and activity limitations (aOR: 1.73 [1.06–2.82]). No differences were found in educational attainment or depression screening. Among T1DM individuals, females had higher odds of prolonged physical impairment. Conclusions: Adults with early-onset T1DM experience persistent socioeconomic and health disparities despite comparable educational levels. These findings highlight the need for integrated, long-term support—including mental health and financial assistance—to mitigate the broader impact of T1DM beyond glycemic control.
Long-term socioeconomic and health disparities among adults diagnosed with type 1 diabetes in childhood
G. Zamagni;G. Tornese;
2025-01-01
Abstract
Introduction: Despite clinical advancements, individuals with type 1 diabetes mellitus (T1DM) diagnosed in childhood may face long-term socioeconomic and health challenges. However, population-based evidence on these outcomes remains scarce. Objectives: To assess disparities in socioeconomic conditions, health status, and daily functioning among adults with T1DM diagnosed before age 18, compared to matched controls, using nationally representative data. Methods: Data were drawn from the Italian PASSI surveillance system (Italian Behavioral Risk Factor Surveillance System, 2011–2018, 2023). Adults aged 18–50 who self-reported a physician-diagnosed diabetes before the age of 18 and were currently receiving insulin therapy were classified as having T1DM cases. Each case was matched by age and sex to two healthy controls. Outcomes included marital status, employment, economic hardship, self-rated health, and number of days with physical, mental, or activity impairment. Logistic regression was used to estimate associations, adjusting for age and sex. Results: Out of 319,801 individuals aged 18-69, 331 individuals (1‰) were classified as having T1DM and were matched with 662 controls. T1DM was associated with higher odds of unemployment (aOR: 1.57 [1.20–2.07]), severe financial difficulty (aOR: 1.81 [1.05–3.13]), and poor self-reported health (aOR: 6.64 [2.53–17.43]). Individuals with T1DM were more likely to report ≥14 days/month of physical (aOR: 2.95 [1.54–5.65]) or mental (aOR: 2.16 [1.46–3.19]) impairment, and activity limitations (aOR: 1.73 [1.06–2.82]). No differences were found in educational attainment or depression screening. Among T1DM individuals, females had higher odds of prolonged physical impairment. Conclusions: Adults with early-onset T1DM experience persistent socioeconomic and health disparities despite comparable educational levels. These findings highlight the need for integrated, long-term support—including mental health and financial assistance—to mitigate the broader impact of T1DM beyond glycemic control.Pubblicazioni consigliate
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