Effect of Socioeconomic Status on Hyperglycemia and Retinopathy Levels in Mexican Americans With NIDDM

Abstract

Mexican Americans have a threefold greater prevalence of non-insulin-dependent diabetes mellitus (NIDDM) than non-Hispanic Whites. Moreover, Mexican-American diabetic people have more severe hyperglycemia and diabetic retinopathy than non-Hispanic White diabetic people. Mexican Americans are predominantly of low socioeconomic status (SES), and low-SES Mexican Americans have a higher prevalence of NIDDM than higher-SES Mexican Americans. Therefore, we hypothesized that among diabetic people, low SES would be associated with more severe hyperglycemia and retinopathy. Three hundred forty-three Mexican Americans and 79 non-Hispanic Whites with NIDDM were identified from the San Antonio Heart Study, a population-based study of diabetes and cardiovascular disease. Hyperglycemia was assessed as the sum of the fasting, 1-h, and 2-h plasma glucose concentrations during a standard oral glucose tolerance test. Retinopathy was assessed by 7 standard stereoretinal photographs. SES was assessed with three indicators: Duncan's socioeconomic index, education, and income. Contrary to expectations, low SES was not associated with greater levels of hyperglycemia or grades of retinopathy.