ArticleBMJ open2017
Education achievement and type 2 diabetes-what mediates the relationship in older adults? Data from the ESTHER study: a population-based cohort study.
Article in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers.
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Who cites it
27 citing papers in PubMed.
- Clinical utility of 1-h post-load glucose in accelerating diagnosis of type 2 diabetes: a prospective cohort study.Acta diabetologica · 2026Article
- Evaluating the Feasibility and Preliminary Effectiveness of a Tailored Diabetes Education Program for Rural Residents.Journal of Appalachian health · 2026Article
- Health effects associated with alcohol consumption: a Burden of Proof study.Nature health · 2026Article
- Examining causal relationships between educational attainment and type 2 diabetes using genetic analysis: findings from the EPIC-InterAct study through Mendelian randomisation.Journal of epidemiology and community health · 2025Article
- Evaluation of sociodemographic and nutrition-related factors for type 2 diabetes risk: a sample from Turkiye.BMC public health · 2025Article
- Mediation of the association between education and dementia by occupational complexity, income, health behaviours and health outcomes.BMC psychiatry · 2025Article
- Prevalence of diabetes and its associated factors in Cape Verde: an analysis of the 2020 WHO STEPS survey on non-communicable diseases risk factors.BMC endocrine disorders · 2024Article
- Increases in Psychological Stress Are Associated With Higher Fasting Glucose in US Chinese Immigrants.Annals of behavioral medicine : a publication of the Society of Behavioral Medicine · 2024Article
- Article
- The effect of diabetes in the multifaceted relationship between education and cognitive function.BMC public health · 2024Article
- Impact of Education as a Social Determinant on the Risk of Type 2 Diabetes Mellitus in Korean Adults.Healthcare (Basel, Switzerland) · 2024Article
- Nearly one in five older adults in Danish nursing homes live with type 2 diabetes.Scandinavian journal of public health · 2024Article
- Lifestyle and metabolic risk factors, and diabetes mellitus prevalence in European countries from three waves of the European Health Interview Survey.Scientific reports · 2024Article
- The role of aldosterone and ideal cardiovascular health in incident diabetes: The Jackson Heart Study.American journal of preventive cardiology · 2023Article
- Identification of the risk factors of type 2 diabetes and its prediction using machine learning techniques.Health systems (Basingstoke, England) · 2023Article
- Obesity mediates the opposite association of education and diabetes in Chinese men and women: Results from the REACTION study.Journal of diabetes · 2022Article
- Levels and Correlates of Numeracy Skills in Lebanese Adults with Diabetes: A Cross-Sectional Study.International journal of environmental research and public health · 2022Article
- Mediators of the association between educational attainment and type 2 diabetes mellitus: a two-step multivariable Mendelian randomisation study.Diabetologia · 2022Article
- Excess Heritability Contribution of Alcohol Consumption Variants in the "Missing Heritability" of Type 2 Diabetes Mellitus.International journal of molecular sciences · 2021Article
- Educational inequalities, urbanicity and levels of non-communicable diseases risk factors: evaluating trends in Argentina (2005-2013).BMC public health · 2021Article
Corrections and comments
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Authors and funding
11 authors.
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Abstract
objectiveThe study aims to identify the mediating factors of the relationship between education achievement and incident type 2 diabetes mellitus (T2DM) in older adults.
designPopulation-based cohort study.
settingParticipants were recruited from the German federal state of Saarland.
participantsParticipants were excluded if they had prevalent T2DM or missing data on prevalent T2DM, missing or zero follow-up time for incident T2DM or were under 50 years of age. The total sample consisted of 7462 individuals aged 50-75 years (42.8% men, mean age 61.7 years) at baseline (2000-02). The median follow-up time was 8.0 years.
methodsCox proportional hazards regression was initially used to determine the direct association between education achievement and incident T2DM. Using the Baron and Kenny approach, we then investigated the associations between education achievement and incident T2DM with the potential mediators. The contribution of each of the putative mediating variables was then calculated.
resultsA clear socioeconomic gradient was observed with regard to T2DM incidence with the lowest educated individuals at a greater risk of developing the disease during the follow-up period: HR (95% CI) high education: 0.52 (0.34 to 0.80); medium education: 0.80 (0.66 to 0.96). Seven of the variables considered explained a proportion of the education-T2DM relationship (body mass index, alcohol consumption, hypertension, fasting triglycerides, high-density lipoprotein (HDL) cholesterol, physical activity and smoking status), where the contribution of the variables ranged from 1.0% to 17.7%. Overall, the mediators explained 31.7% of the relationship.
conclusionBy identifying the possible mediating factors of the relationship between education achievement and incident T2DM in older adults, the results of this study can be used to assist with the development of public health strategies that aim to reduce socioeconomic inequalities in T2DM.
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