Examining disparities in glycemic management: a comprehensive retrospective study on rural population

Abstract Introduction Residing in rural or remote areas is often linked to compromised access to health services, directly affecting the feasibility of follow-up on patients with diabetes. There is a gap in the literature concerning the quality of diabetes care in rural areas and the relationship be...

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Main Authors: Andria Papazachariou, Onoufrios Malikides, Vironas Malikides, Nektaria Vasilaki, Maria Stamatelatou, Ioanna Papakitsou, Eleni Papadokostaki, Theodosios D. Filippatos
Format: Article
Language:English
Published: Springer 2025-07-01
Series:Discover Public Health
Online Access:https://doi.org/10.1186/s12982-025-00457-1
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author Andria Papazachariou
Onoufrios Malikides
Vironas Malikides
Nektaria Vasilaki
Maria Stamatelatou
Ioanna Papakitsou
Eleni Papadokostaki
Theodosios D. Filippatos
author_facet Andria Papazachariou
Onoufrios Malikides
Vironas Malikides
Nektaria Vasilaki
Maria Stamatelatou
Ioanna Papakitsou
Eleni Papadokostaki
Theodosios D. Filippatos
author_sort Andria Papazachariou
collection DOAJ
description Abstract Introduction Residing in rural or remote areas is often linked to compromised access to health services, directly affecting the feasibility of follow-up on patients with diabetes. There is a gap in the literature concerning the quality of diabetes care in rural areas and the relationship between glycemic control and distance to medical care. Methods An 8-month retrospective cohort study of factors affecting glycemic control among 932 individuals with diabetes, who sought medical care in a rural area. Demographics, comorbidities and laboratory measurements were retrieved through patient interviews, from the national electronic prescription system and hospital’s medical records. Distance in kilometers or in minutes from medical center was calculated using a geographic dataset. Results Participants (n = 632) resided within a half-hour proximity to reference center, demonstrated better glycemic control, with a mean HbA1c level of 7.20 ± 0.7%, as opposed to those (n = 300) who lived more than half-hour away, who exhibited a mean HbA1c level of 7.34 ± 0.8% (p = 0.016). HbA1c levels exhibit a significant correlation with both the time in minutes and the distance in kilometers from the rural area reference center. Multivariate linear regression analyses showed that distance in kilometers or in minutes is an independent factor influencing HbA1c levels. Conclusion The distance to medical services is an important factor of glycemic control in patients with diabetes, underlying the importance of improvements in the health system in rural areas.
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spelling doaj-art-50f6bd528e944b5d90090f9f31e508fa2025-08-20T03:42:48ZengSpringerDiscover Public Health3005-07742025-07-012211610.1186/s12982-025-00457-1Examining disparities in glycemic management: a comprehensive retrospective study on rural populationAndria Papazachariou0Onoufrios Malikides1Vironas Malikides2Nektaria Vasilaki3Maria Stamatelatou4Ioanna Papakitsou5Eleni Papadokostaki6Theodosios D. Filippatos7Department of Internal Medicine, University Hospital of HeraklionDepartment of Cardiology, University Hospital of HeraklionDepartment of Internal Medicine, University Hospital of HeraklionDepartment of Internal Medicine, General Hospital of SitiaDepartment of Internal Medicine, General Hospital of SitiaDepartment of Internal Medicine, University Hospital of HeraklionDepartment of Internal Medicine, University Hospital of HeraklionDepartment of Internal Medicine, University Hospital of HeraklionAbstract Introduction Residing in rural or remote areas is often linked to compromised access to health services, directly affecting the feasibility of follow-up on patients with diabetes. There is a gap in the literature concerning the quality of diabetes care in rural areas and the relationship between glycemic control and distance to medical care. Methods An 8-month retrospective cohort study of factors affecting glycemic control among 932 individuals with diabetes, who sought medical care in a rural area. Demographics, comorbidities and laboratory measurements were retrieved through patient interviews, from the national electronic prescription system and hospital’s medical records. Distance in kilometers or in minutes from medical center was calculated using a geographic dataset. Results Participants (n = 632) resided within a half-hour proximity to reference center, demonstrated better glycemic control, with a mean HbA1c level of 7.20 ± 0.7%, as opposed to those (n = 300) who lived more than half-hour away, who exhibited a mean HbA1c level of 7.34 ± 0.8% (p = 0.016). HbA1c levels exhibit a significant correlation with both the time in minutes and the distance in kilometers from the rural area reference center. Multivariate linear regression analyses showed that distance in kilometers or in minutes is an independent factor influencing HbA1c levels. Conclusion The distance to medical services is an important factor of glycemic control in patients with diabetes, underlying the importance of improvements in the health system in rural areas.https://doi.org/10.1186/s12982-025-00457-1
spellingShingle Andria Papazachariou
Onoufrios Malikides
Vironas Malikides
Nektaria Vasilaki
Maria Stamatelatou
Ioanna Papakitsou
Eleni Papadokostaki
Theodosios D. Filippatos
Examining disparities in glycemic management: a comprehensive retrospective study on rural population
Discover Public Health
title Examining disparities in glycemic management: a comprehensive retrospective study on rural population
title_full Examining disparities in glycemic management: a comprehensive retrospective study on rural population
title_fullStr Examining disparities in glycemic management: a comprehensive retrospective study on rural population
title_full_unstemmed Examining disparities in glycemic management: a comprehensive retrospective study on rural population
title_short Examining disparities in glycemic management: a comprehensive retrospective study on rural population
title_sort examining disparities in glycemic management a comprehensive retrospective study on rural population
url https://doi.org/10.1186/s12982-025-00457-1
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