Diabetic complications common in people who do not live in urban areas

WEDNESDAY, March 27, 2024 (HealthDay News) — Adults with diabetes who live in small towns are disproportionately affected by diabetes complications, a study published online Feb. 22 shows. It became clear. diabetes care.

Kyle Steiger, MD, of the Mayo Clinic in Rochester, Minnesota, and colleagues used the OptumLabs data warehouse to study 2.9 million commercially insured adults and Medicare Advantage beneficiaries with diabetes in the United States (January 2012). to December 2021) and compared the risk of diabetic complications.remote areas (population <2,500）、小さな町（人口 2,500 ～ 50,000）、都市（人口 >50,000).

Researchers found that compared to urban residents, residents of remote areas had an increased risk (hazard ratio) of myocardial infarction. [HR], 1.06) and revascularization (HR, 1.04). However, residents in remote areas had lower risks of hyperglycemia (HR, 0.90) and stroke (HR, 0.91). Small town residents are at higher risk of hyperglycemia (HR, 1.06), hypoglycemia (HR, 1.15), end-stage renal disease (HR, 1.04), myocardial infarction (HR, 1.10), heart failure (HR, 1.05), and amputation. was higher. Compared to urban residents, the risk of stroke (HR, 1.05), other lower extremity complications (HR, 1.02), and revascularization (HR, 1.05) was lower compared to urban residents. was low (HR, 0.95). Residents of remote areas had lower risks of hyperglycemia (HR, 0.85), hypoglycemia (HR, 0.92), and heart failure (HR, 0.94) compared with residents of small towns. There were no geographic differences in the risk of retinopathy and atrial fibrillation/flutter.

“While our study did not address why these differences exist, people living outside of urban areas have less access to care from a diabetes specialist and less diabetes self-management education. “We know that they are less likely to be able to access diabetes and be monitored for diabetes complications,'' co-author Ether Davis, MD, of the University of Maryland, Baltimore, said in a statement. “Our study builds on fundamental evidence to demonstrate the potential impact of these differences on preventable diabetes complications.”

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