Association between Socioeconomic status and delay in seeking care for diabetes mellitus.

Abstract

Objective: To examine associations between SES indicators and patient delay duration prior to type 2 diabetes mellitus diagnosis. Study Design: Analytical Cross Sectional study. Setting: Bahawal Victoria Hospital/Quaid-e-Azam Medical College, Bahawalpur. Period: June to December 2025. Methods: Total 274 adults with physician confirmed type 2 diabetes diagnosed within prior 6–12 months were included. Patient delay was defined as days from symptom recognition to first healthcare consultation (≥30 days=substantial delay). SES was assessed via household income (tertiles), education, occupation, and asset-based wealth index. Multivariable logistic regression adjusted for demographic, clinical and health system factors; stratified analyses explored effect modification. Results: Median patient delay was 28 days (IQR:14–52). A pronounced socioeconomic gradient existed: 64.1% of low-SES participants experienced delay ≥30 days versus 26.4% of high-SES (p<0.001). After adjustment, low income (aOR=2.84, 95% CI: 1.49–5.42) and minimal education (aOR=2.31, 95% CI: 1.22–4.38) independently predicted delay. Associations were stronger among women (aOR=4.12) than men (aOR=2.18; p=0.038) and in rural (aOR=3.67) versus urban settings (aOR=1.94; p=0.047). Financial constraints and agricultural labor demands predominated as barriers for disadvantaged groups. Conclusion: Socioeconomic disadvantage substantially prolongs patient delay in diabetes diagnosis with compounded vulnerabilities for women and rural populations. Multilevel interventions financial protection for outpatient services, gender-sensitive community outreach, transportation support and context-specific health education are urgently required to mitigate diagnostic delays and prevent complications.