Individual and partner's level of occupation and the association with HbA_1c levels in people with Type 2 diabetes mellitus: the Dutch Diabetes Pearl cohort

Aims: Individual indicators of socio-economic status have been associated with glycaemic control in people with Type 2 diabetes, but little is known about the association between partner’s socio-economic status and HbA_1c levels. We therefore examined the cross-sectional association between individual and partner’s level of occupation on HbA_1c levels in people with Type 2 diabetes in the Netherlands. Methods: We included people with Type 2 diabetes with a partner who were treated in primary, secondary and tertiary care in the Diabetes Pearl cohort. Occupational level was classified according to International Standard Classification of Occupations (ISCO)-08 skill levels. Linear regression analyses were performed stratified for sex, and corrected for age, recruitment centre and diabetes medication. Results: In total, 3257 participants (59.8% men, mean 62.2±9.4 years) were included. For men, having a partner with an intermediate level of occupation was associated with lower HbA_1c levels [e.g. ISCO level 3: –2 mmol/mol (95% CI –4;–1) or -0.2% (95% CI –0.4;–0.1)], compared with having a partner of the highest occupational level (ISCO level 4). In women, having an unemployed partner was associated with higher HbA_1c levels [14 mmol/mol (95% CI 6; 22) or 1.3% (95% CI 0.6; 2.0)], compared with having a partner of the highest occupational level. Conclusions: Partner's occupational status provided additional information on the association between socio-economic status and HbA_1c levels in people with Type 2 diabetes. Women seemed to benefit from a partner with a higher occupational status, while men seemed to benefit from a partner with a lower status. Because of the cross-sectional nature of the present study, more research is necessary to explore this association.