Disparities in Acute and Chronic Complications of Diabetes Along the U.S. Rural-Urban Continuum

• DOI: 10.2337/figshare.25189220.v1
• Publication Date: 2024-02-22T22:25:02Z
• Authors: Kyle Steiger; Jeph Herrin; Kavya Sindhu Swarna; Esa M Davis; Rozalina G McCoy
• Keywords: Continuum of care

<p dir="ltr">Objective: To determine the relative hazards of acute and chronic diabetes complications among those with across U.S. rural-urban continuum. </p><p dir="ltr">Research Design Methods: This retrospective cohort study used OptumLabs® Data Warehouse, a deidentified dataset commercial Medicare Advantage beneficiaries to follow 2,901,563 adults (age>18) between January 1, 2012 December 31, 2021. We compared adjusted hazard ratios in remote areas (population <2,500), small towns 2,500-50,000), cities >50,000).</p><p dir="ltr">Results: Compared residents cities, had greater myocardial infarction (HR 1.06, 95% CI 1.02-1.10) revascularization 1.04, 1.02-1.06) but lower hyperglycemia 0.90, 0.83-0.98) stroke 0.91, 0.88-0.95). 1.02-1.10), hypoglycemia 1.15, 1.12-1.18), end-stage kidney disease 1.03-1.06), 1.10, 1.08-1.12), heart failure 1.05, amputation 1.02-1.09), other extremity 1.02, 1.01-1.03), 1.04-1.06) smaller 0.95, 0.94-0.97). towns, 0.85, 0.78-0.93), 0.92, 0.87-0.97), 0.94, 0.91-0.97). Hazards retinopathy atrial fibrillation/flutter did not vary geographically.</p><p dir="ltr">Conclusions: Adults were disproportionately impacted by diabetes. Future studies should probe for reasons underlying these disparities.</p>