دورية أكاديمية
Disparities in Acute and Chronic Complications of Diabetes Along the U.S. Rural-Urban Continuum.
| العنوان: | Disparities in Acute and Chronic Complications of Diabetes Along the U.S. Rural-Urban Continuum. |
|---|---|
| المؤلفون: | Steiger K; Internal Medicine Residency, Mayo Clinic, Rochester, MN., Herrin J; Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT., Swarna KS; Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN.; OptumLabs, Eden Prairie, MN., Davis EM; Department of Family and Community Medicine, University of Maryland School of Medicine, Baltimore, MD.; Institute for Health Computing, University of Maryland, Bethesda, MD., McCoy RG; Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN.; OptumLabs, Eden Prairie, MN.; Institute for Health Computing, University of Maryland, Bethesda, MD.; Division of Endocrinology, Diabetes, and Nutrition, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD. |
| المصدر: | Diabetes care [Diabetes Care] 2024 May 01; Vol. 47 (5), pp. 818-825. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: American Diabetes Association Country of Publication: United States NLM ID: 7805975 Publication Model: Print Cited Medium: Internet ISSN: 1935-5548 (Electronic) Linking ISSN: 01495992 NLM ISO Abbreviation: Diabetes Care Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: Alexandria Va : American Diabetes Association Original Publication: New York, American Diabetes Assn. |
| مواضيع طبية MeSH: | Diabetes Mellitus*/epidemiology , Hyperglycemia* , Myocardial Infarction*/epidemiology , Myocardial Infarction*/etiology , Diabetes Complications* , Stroke* , Hypoglycemia* , Heart Failure*/epidemiology , Heart Failure*/etiology, Adult ; Humans ; Aged ; United States/epidemiology ; Adolescent ; Retrospective Studies ; Medicare |
| مستخلص: | Objective: To determine the relative hazards of acute and chronic diabetes complications among people with diabetes across the U.S. rural-urban continuum. Research Design and Methods: This retrospective cohort study used the OptumLabs Data Warehouse, a deidentified data set of U.S. commercial and Medicare Advantage beneficiaries, to follow 2,901,563 adults (age ≥18 years) with diabetes between 1 January 2012 and 31 December 2021. We compared adjusted hazard ratios (HRs) of diabetes complications in remote areas (population <2,500), small towns (population 2,500-50,000), and cities (population >50,000). Results: Compared with residents of cities, residents of remote areas had greater hazards of myocardial infarction (HR 1.06 [95% CI 1.02-1.10]) and revascularization (HR 1.04 [1.02-1.06]) but lower hazards of hyperglycemia (HR 0.90 [0.83-0.98]) and stroke (HR 0.91 [0.88-0.95]). Compared with cities, residents of small towns had greater hazards of hyperglycemia (HR 1.06 [1.02-1.10]), hypoglycemia (HR 1.15 [1.12-1.18]), end-stage kidney disease (HR 1.04 [1.03-1.06]), myocardial infarction (HR 1.10 [1.08-1.12]), heart failure (HR 1.05 [1.03-1.06]), amputation (HR 1.05 [1.02-1.09]), other lower-extremity complications (HR 1.02 [1.01-1.03]), and revascularization (HR 1.05 [1.04-1.06]) but a smaller hazard of stroke (HR 0.95 [0.94-0.97]). Compared with small towns, residents of remote areas had lower hazards of hyperglycemia (HR 0.85 [0.78-0.93]), hypoglycemia (HR 0.92 [0.87-0.97]), and heart failure (HR 0.94 [0.91-0.97]). Hazards of retinopathy and atrial fibrillation/flutter did not vary geographically. Conclusions: Adults in small towns are disproportionately impacted by complications of diabetes. Future studies should probe for the reasons underlying these disparities. (© 2024 by the American Diabetes Association.) |
| References: | JAMA Netw Open. 2021 Dec 1;4(12):e2138438. (PMID: 34964856) Ann Fam Med. 2023 May-Jun;21(3):234-239. (PMID: 37217319) J Rural Health. 2015 Summer;31(3):326-33. (PMID: 25953431) Diabetologia. 2022 Dec;65(12):2078-2083. (PMID: 36085381) NCHS Data Brief. 2021 Sep;(417):1-8. (PMID: 34582331) Health Aff (Millwood). 2019 Dec;38(12):2003-2010. (PMID: 31794316) Rural Remote Health. 2010 Apr-Jun;10(2):1320. (PMID: 20509722) JAMA. 1982 Sep 3;248(9):1073-6. (PMID: 7109199) Diabetes Care. 2024 Jan 1;47(1):26-43. (PMID: 37909353) JAMA Netw Open. 2022 Apr 1;5(4):e228399. (PMID: 35446395) Med Care. 2021 Oct 1;59(Suppl 5):S413-S419. (PMID: 34524237) Am J Public Health. 2016 Aug;106(8):1463-9. (PMID: 27310341) Diabetes Metab Res Rev. 2021 Jul;37(5):e3410. (PMID: 33021052) Diabetes Educ. 2013 May-Jun;39(3):327-34. (PMID: 23482514) Ann Intern Med. 2007 Oct 16;147(8):573-7. (PMID: 17938396) J Surg Res. 2021 Feb;258:170-178. (PMID: 33011448) Arch Environ Health. 2003 Oct;58(10):642-8. (PMID: 15562636) JAMA Netw Open. 2020 Jan 3;3(1):e1919099. (PMID: 31922562) J Community Health. 2010 Aug;35(4):365-74. (PMID: 20386968) J Rural Health. 2020 Jun;36(3):410-415. (PMID: 30802321) JAMA Netw Open. 2023 Jan 3;6(1):e2250602. (PMID: 36662531) Health Aff (Millwood). 2014 Jul;33(7):1187-94. (PMID: 25006145) Occup Environ Med. 1999 Jan;56(1):14-21. (PMID: 10341741) Diabetes Care. 2022 Aug 1;45(8):1788-1798. (PMID: 35724305) |
| معلومات مُعتمدة: | K23 DK114497 United States DK NIDDK NIH HHS; Grant K23DK114497 United States DK NIDDK NIH HHS; Grant K23DK114497 United States DK NIDDK NIH HHS |
| تواريخ الأحداث: | Date Created: 20240222 Date Completed: 20240422 Latest Revision: 20240427 |
| رمز التحديث: | 20240427 |
| مُعرف محوري في PubMed: | PMC11043221 |
| DOI: | 10.2337/dc23-1552 |
| PMID: | 38387066 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1935-5548 |
|---|---|
| DOI: | 10.2337/dc23-1552 |