Abstract
Aim
To investigate differences in access to services and health outcomes between people
living with Type 1 (T1DM) and Type 2 (T2DM) diabetes in rural/regional and metropolitan
areas.
Methods
Diabetes MILES—Australia was a national postal/online survey of persons registered
with the National Diabetes Services Scheme. Selected variables, including utilisation
of health care services and self-care indicators, were analysed for 3338 respondents
with T1DM (41%) or T2DM (59%).
Results
Respondents from rural/regional (n = 1574, 48%) and metropolitan areas were represented equally (n = 1700, 52%). After adjusting for diabetes duration, demographic and socioeconomic variables,
rural/regional respondents with T1DM (RR 0.90, 95% CI 0.83–0.97) and T2DM (RR 0.69,
95% CI 0.59–0.81) were less likely to report consulting an endocrinologist during
the past 12 months. Rural/regional respondents with T1DM were more than twice as likely
to have accessed a community/practice nurse for diabetes care (RR 2.22, 95% CI 1.25–3.93)
while those with T2DM were more likely to have accessed a diabetes educator (RR 1.21,
95% CI 1.07–1.36) or dietician (RR 1.17, 95% CI 1.07–1.36). For the T1DM and T2DM
groups were no differences between rural/regional and metropolitan respondents in
self-reported hypoglycaemic events during past week and the majority of self-care
indicators.
Conclusions
Despite a lack of access to medical specialists, respondents with T1DM and T2DM living
in rural/regional areas did not report worse health or self-care indicators. The results
suggest that multidisciplinary primary services in rural areas may be providing additional
care for people with diabetes, compensating for poor access to specialists.
Keywords
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Article info
Publication history
Published online: April 08, 2013
Accepted:
March 6,
2013
Received in revised form:
February 14,
2013
Received:
December 12,
2012
Identification
Copyright
© 2013 Published by Elsevier Inc. All rights reserved.
