Endocrine Abstracts

Introduction: Social deprivation is increasingly recognised as a risk factor for complications of diabetes, including diabetic kidney disease. The effect of deprivation on rate of decline in renal function has not been explored in the Irish Health System to date.

Aim: The aim of this study is to explore the association between social deprivation and the development and progression of diabetic kidney disease in a cohort of adults living with diabetes in Ireland.

Methods: This is a retrospective cohort study using an existing dataset of 4464 people living with diabetes who attended the diabetes centre at University Hospital Galway from 2012 to 2016. The database contains clinical, demographic and laboratory data and was updated to include longitudinal laboratory measurements up to January 2023. Individual’s addresses were used to calculate deprivation indices using the Pobal Haase Pratschke (HP) deprivation index. Rate of renal function decline (absolute and percent) was calculated using linear mixed-effect models.

Results: In participants with type 1 diabetes, there was a statistically significant difference in baseline creatinine (higher in more deprived group). In participants with type 2 diabetes, there was a statistically significant difference in baseline smoking rates, body mass index and systolic blood pressure (all higher in more deprived groups) despite a higher rate of antihypertensive use in more deprived groups. Unadjusted linear regression models showed a statistically significant relationship between absolute (P = 0.016) and percent (P = 0.022) decline in renal function and deprivation indices (faster decline in more deprived participants).

Conclusions: Our study demonstrates differences in baseline clinically relevant variables across deprivation categories. Furthermore, we have demonstrated a faster rate of decline in renal function in more deprived people living with diabetes. This highlights a need for targeted interventions for deprived populations, in order to mitigate the additional risk imposed by social deprivation.