Rural diabetics at Mayo had worse health results than urban ones, maybe because they see doctors and specialists less

Rural diabetics have slightly worse health outcomes than their urban counterparts, perhaps because they see diabetes specialists and other doctors less frequently, according to researchers at the Mayo Clinic in Rochester, Minn. Their study looked at 45,279 Mayo patients with a five-part standard for diabetes care called the D5 metric: absence of tobacco usage, maintaining hemoglobin A1C levels below 8%, keeping blood pressure below 140/90, using statin drugs, and taking aspirin. Forty percent of the rural patients met all five criteria while 43% of the urban patients did. 

"Rural patients had a lower average number of outpatient visits (3.2 visits) in contrast to urban patients (3.9 visits)," Mayo reports. "Furthermore, rural patients had fewer visits to endocrinologists, with only 5.5% attending such appointments, whereas 9.3% of urban patients did. . . . The researchers reached the conclusion that rural patients experienced poorer quality outcomes in managing their diabetes compared to urban patients, despite both groups being part of the same integrated health system. The study team speculated that the lower frequency of visits and limited access to specialty care in rural areas could be potential factors contributing to this disparity. . . . The authors of the study argue that broader interventions are necessary to enhance the quality of care provided by doctors to patients with diabetes residing in rural areas."