Danish health registries were used to follow 81,361 people with newly diagnosed concurrent type 2 diabetes and cardiovascular disease from 2015 to 2022, measuring initiation of SGLT2 inhibitors and GLP-1 receptor agonists. The crude gradient by education disappeared after multivariable adjustment (IRR 0.95 for women, 1.00 for men), but occupational and marital status did not - unemployed men had an IRR of 0.77 and unemployed women 0.81 against the employed, with retired, divorced, widowed and unmarried individuals also initiating less. Non-initiation was therefore patterned by work and partnership rather than by schooling.
Why it is interesting: In a system with universal coverage, the differential in who starts guideline-recommended cardioprotective drugs tracks employment and marital status rather than education.