ArticleBMJ open diabetes research & care2022
Glycemic outcomes among rural patients in the type 1 diabetes T1D Exchange registry, January 2016-March 2018: a cross-sectional cohort study.
Article in BMJ open diabetes research & care, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Can Behavioral Interventions Promote Health Equity in Pediatric Type 1 Diabetes? A Narrative Review of Promising Treatments.Current diabetes reports · 2026Review
- Development of a Diabetes Rural Stakeholder Research Team and Patient-Centered Research Agenda.OTJR : occupation, participation and health · 2026Article
- SWIIM study protocol: a pre-post study evaluating the implementation of an established pediatric diabetes management program to improve glycemic outcomes for children and young people with type 1 diabetes.Frontiers in endocrinology · 2026Article
- Rural Caregiver Perceptions on the Content and Receipt of a Diabetes Management Telehealth Occupation-Based Coaching Intervention.OTJR : occupation, participation and health · 2025Article
- Disparities in Continuous Glucose Monitor Use Between Children With Type 1 Diabetes Living in Urban and Rural Areas.Diabetes care · 2024Article
- Patterns and Trends in Continuous Glucose Monitoring Utilization Among Commercially Insured Individuals With Type 1 Diabetes: 2010-2013 to 2016-2019.Clinical diabetes : a publication of the American Diabetes Association · 2024Article
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Abstract
introductionDoes rural status influence glycemic outcomes among participants in the type 1 diabetes T1D Exchange clinic registry? RESEARCH DESIGN AND
methodsData from the T1D Exchange clinic registry between January 2016 and March 2018 were identified by rural-urban status and stratified by age and hemoglobin A1c (HbA1c). Multivariable regression modeling was performed to isolate HbA1c differences. A full model including all significant (p<0.05 via two-sided testing) differential factors was determined with an additional indicator for rural status, and adjusted for duration of diabetes, use of continuous glucose monitoring device, age, race/ethnicity, and private insurance status. The model was reduced using backwards elimination stepwise procedures until only significant factors remained.
resultsMean HbA1c levels for all rural participants were significantly higher (8.71%; 72 mmol/mol) compared with the urban group (8.48%; 69 mmol/mol), p<0.001. For youth under 13 years of age, rural participants had a higher mean HbA1c (8.65%; 71 mmol/mol) compared with urban (8.45% 69 mmol/mol), p=0.022. Rural youth (13-<18 years) had a higher mean HbA1c (9.39%; 79 mmol/mol) than urban youth (9.14%; 76 mmol/mol), p<0.001. Rural young adults (18-<26 years) had a higher mean HbA1c (9.07%; 76 mmol/mol) than urban young adults (8.88%; 74 mmol/mol), p=0.042. Rural adults (≥26 years; n=589) were the only group that did not have a higher mean HbA1c (7.76%, 61.3 mmol) than urban adults (n=4770; 7.72%, 60.9 mmol/mol), p=0.503. Rural locale was highly significant (beta=0.175, p<0.001) despite controlling for potentially confounding differences between rural and urban groups.
conclusionsAmong this T1D Exchange cohort, there is a pattern of higher mean HbA1c being associated with rural status, even after adjustment for characteristic differences, most strikingly among those under 26 years of age. This disparity and contributing factors need to be more thoroughly studied to provide effective solutions.
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