Published online Aug 15, 2025. doi: 10.4239/wjd.v16.i8.106927
Revised: May 4, 2025
Accepted: June 24, 2025
Published online: August 15, 2025
Processing time: 156 Days and 20.5 Hours
Social determinants of health are social and economic factors that influence health intervention outcomes. Type 2 diabetes is a highly prevalent disease, primarily affecting individuals in low-to-middle-income countries. However, the association between social determinants and cardiovascular complications in type 2 diabetes has not been widely studied.
To examine the relationship between social determinants of health and car
We conducted a retrospective cohort study with an analytical component at a national-level referral hospital for military personnel in Bogota, Colombia. Patients treated at the diabetes clinic between September 2021 and December 2022 who met the inclusion criteria were included. A total of 583 patients participated in the study. We performed descriptive, bivariate, and binary logistic regression analyses, adjusting for confounding variables.
Among the 583 patients included, urban residency [odds ratio (OR) = 3.05, 95% confidence interval (CI): 1.01-9.20] and a middle or high educational level (OR = 2.33, 95%CI: 1.14-4.72) were associated with an increased risk of coronary artery disease. Additionally, receiving diabetes education beyond that provided by the clinic (OR = 2.15, 95%CI: 1.14-4.05) and lack of access to spaces for physical activity (OR = 4.05, 95%CI: 1.31-12.5) were associated with a higher risk of diabetic nephropathy and cerebrovascular disease, respectively.
Programs for diabetes management should account for social determinants of health that contribute to cardiovascular complications and increased healthcare costs. Population-based studies are needed to guide targeted interventions and clarify causal relationships.
Core Tip: Cardiac complications related to type 2 diabetes are affected by the condition of the patient and social determinants of health. These cardiovascular complications result in a lower quality of life and a more significant economic burden on health systems. Among the social determinants of health analyzed, urban residents and those with a middle or high educational level showed a higher risk of coronary artery disease. Receiving additional education beyond that provided by the diabetes clinic and individuals without the availability of spaces for physical activity showed a higher risk of developing diabetes nephropathy and cerebrovascular disease.