Disparities in Acute and Chronic Complications of Diabetes Along the U.S. Rural-Urban Continuum
Authors' conclusion
Adults in small towns are disproportionately impacted by complications of diabetes. Future studies should probe for the reasons underlying these disparities.
Study context
- Population
- Adults (age ≥18 years) with diabetes, U.S. commercial and Medicare Advantage beneficiaries (OptumLabs Data Warehouse), 2012–2021
- Participants
- 2,901,563 adults
- Exposure
- Remote areas vs small towns vs cities
- Outcome
- Acute and chronic diabetes complications (adjusted HRs)
Main finding
As reported in the abstract
Diabetes complications (adjusted HRs)
Hazard ratio (95% CI)
Remote areasvs CitiesMI
1.06(1.02–1.10)
Remote areasvs Citiesrevascularization
1.04(1.02–1.06)
Remote areasvs Citieshyperglycemia
0.90(0.83–0.98)
Remote areasvs Citiesstroke
0.91(0.88–0.95)
Small townsvs Citieshyperglycemia
1.06(1.02–1.10)
Small townsvs Citieshypoglycemia
1.15(1.12–1.18)
Small townsvs Citiesend-stage kidney disease
1.04(1.03–1.06)
Small townsvs CitiesMI
1.10(1.08–1.12)
Small townsvs CitiesHF
1.05(1.03–1.06)
Small townsvs Citiesamputation
1.05(1.02–1.09)
Small townsvs Citiesother lower-extremity complications
1.02(1.01–1.03)
Small townsvs Citiesrevascularization
1.05(1.04–1.06)
Small townsvs Citiesstroke
0.95(0.94–0.97)
Remote areasvs Small townshyperglycemia
0.85(0.78–0.93)
Remote areasvs Small townshypoglycemia
0.92(0.87–0.97)
Remote areasvs Small townsHF
0.94(0.91–0.97)
Observational data: associations, not effects.
Original publication
Disparities in Acute and Chronic Complications of Diabetes Along the U.S. Rural-Urban Continuum. Diabetes Care. Published 22 February 2024. doi:10.
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