Diabetes Complication Risk Higher in US Small Towns, Study Finds

A recent study conducted by Kyle Steiger, MD, and colleagues sheds light on the disparities in diabetes complication rates among residents of small towns, cities, and remote areas in the United States. Published in Diabetes Care, the study analyzed data from the OptumLabs Data Warehouse, encompassing over 2.9 million adults with diabetes from 2012 to 2021.

According to the study, individuals residing in small towns faced significantly higher risks of various diabetes-related complications compared to their urban counterparts. The findings revealed a stark contrast in complication rates across different geographic locations, emphasizing the need for targeted interventions to address these disparities.

Key Takeaways from the Study:

• Geographic Disparities: Relative to urban dwellers, individuals in remote areas experienced elevated risks of myocardial infarction and revascularization but lower risks of hypoglycemia and stroke. Conversely, those in small towns had increased risks of hyperglycemia, hypoglycemia, end-stage kidney disease, myocardial infarction, heart failure, amputation, lower-extremity complications, and revascularization, albeit with a lower risk of stroke.
• Clinical Implications: The study underscores the importance of understanding the underlying factors contributing to differential diabetes outcomes along the rural-urban continuum. By identifying complications with the most significant disparities, policymakers and healthcare professionals can target interventions to mitigate these discrepancies and enhance patient care.

Dr. Steiger emphasized the need for further research to delve into the root causes of these geographic variations in diabetes complications. Despite the study’s limitations, including the absence of data on race/ethnicity and the disproportionate representation of urban populations, the findings provide valuable insights into the landscape of diabetes care in the US.

The study was supported by the National Institute of Diabetes and Digestive and Kidney Diseases, with Dr. Steiger disclosing no conflicts of interest. While more research is warranted to validate and expand upon these findings, the study serves as a pivotal step toward addressing the complex challenges faced by individuals with diabetes in small-town America.