Sociodemographic Disparities and Prevalence of Type 2 Diabetes Multimorbidities in Serbia

Abstract Introduction In many countries, including low- and middle-income nations, the prevalence of diabetes is on the rise. Type 2 Diabetes Mellitus (T2DM) is frequently accompanied by the presence of one or more long-term conditions (LTCs), however, their link to patients’ socioeconomic traits remains unclear in many LMICs, particularly in the Western Balkans. Thus, our objective was to investigate the risk for the development of T2DM and one or more LTCs in Serbia among different sociodemographic population groups. Methods We conducted a secondary analysis of data from the National Health Surveys of 2013 and 2019, focusing on individuals aged 45 and above. Utilizing multinomial logistic regression models, we explored the relative risk ratios (RRRs), along with 95% confidence intervals (CI) and predicted probabilities, to examine the sociodemographic characteristics of participants across various disease groups, distinguishing between those with and without T2DM and one or more LTCs. Results The prevalence rates for comorbidities and multimorbidities of T2DM were 8.8% and 29.5%, respectively. In 2019, compared to 2013, there was a rise in the prevalence of T2DM and 1 LTC for 9.4%, and decrease in the prevalence of T2DM and 2 or more LTCs for 6,9%. Most commonly, T2DM was associated with stroke, myocardial infarction, and liver cirrhosis. The highest risk for T2DM and 1 LTC was observed for females in the most disadvantaged fifth quintile of the wealth index (RRR 1.83, 95% CI 1.09-3.07, p = 0.022) compared to those in the most advantaged first quintile. Conclusions Socio-economic inequalities contribute to the risk of developing LTCs in Serbia, which must be considered in the early detection and management of diseases and addressed by innovative service models. Similar studies should be conducted in the wider region to explore the feasibility of larger joint research initiatives. Key messages • There are socio-economic disparities in the co-occurrence of Type 2 Diabetes Mellitus and long-term conditions in Serbia, where deprived women of older age are most at risk. • Innovative approaches in the early identification of populations at risk for multimorbidities can help in disease management and timely prevention of complications.