Social deprivation and diabetic patients

BMJ 1994;308:1240 (7 May)

Letters

Social deprivation and diabetic patients

EDITOR, - William F Kelly and colleagues link social deprivationand illness in diabetic patients.¹ It would have been informativeto know whether the patients living in the deprived wards werenot using insulin simply because they had non-insulin dependentdiabetes, which would be in agreement with their older age.Was the prevalence of insulin dependent diabetes comparablein the wards? In an earlier Danish study that linked diabeticketoacidosis to social deprivation, patients from the lowestsocial classes had more severe ketoacidosis than patients fromhigher social classes.²

We evaluated patients who were admitted to our hospital withdiabetic ketoacidosis between January 1987 and March 1990. Onlypatients over 15 years old were included, and diabetic ketoacidosiswas defined as plasma bicarbonate <18 mmol/l, severe ketonuria,and raised blood glucose. These criteria had been used in theprevious Danish study.²