TY - JOUR
T1 - Burden and management of type 2 diabetes in rural United States
AU - Dugani, Sagar B.
AU - Mielke, Michelle M.
AU - Vella, Adrian
N1 - Funding Information:
The authors are grateful to Ms Dana Gerberi MLS AHIP, academic librarian at Mayo Clinic Libraries, for assistance in developing the scientific literature search and managing the references and Ms. Marla Battey, Mayo Clinic Libraries, for assistance in obtaining full-texts of articles. Sagar B. Dugani was supported by the Robert and Elizabeth Strickland Career Development Award, Mayo Clinic, Rochester, MN, USA; Michelle M. Mielke was supported by National Institute on Aging grant R01 AG49704.
Funding Information:
The authors are grateful to Ms Dana Gerberi MLS AHIP, academic librarian at Mayo Clinic Libraries, for assistance in developing the scientific literature search and managing the references and Ms. Marla Battey, Mayo Clinic Libraries, for assistance in obtaining full‐texts of articles. Sagar B. Dugani was supported by the Robert and Elizabeth Strickland Career Development Award, Mayo Clinic, Rochester, MN, USA; Michelle M. Mielke was supported by National Institute on Aging grant R01 AG49704.
Publisher Copyright:
© 2020 John Wiley & Sons Ltd.
PY - 2021/7
Y1 - 2021/7
N2 - In the United States, rural areas have a higher burden of type 2 diabetes (T2DM) compared to urban areas. However, there is limited information on risk factors and interventions that improve the primary prevention and management of T2DM in rural areas. To synthesize current knowledge on T2DM in rural areas and to guide healthcare providers and policy makers, we reviewed five scientific databases and the grey literature over the last decade (2010–2020). We described classification systems for rurality and the T2DM burden based on rurality and region (West, South, Midwest, and Northeast). We highlighted risk factors for T2DM in rural compared to urban areas, and summarized interventions to screen and manage T2DM based on opportunistic screening, T2DM self-management, community-based initiatives, as well as interventions targeting comorbidities and T2DM. Several studies identified the co-existence of T2DM and depression/psychological symptoms, which could reduce adherence to non-pharmacologic and pharmacologic management of T2DM. We highlighted the role of technology in education and counselling of patients with geographic and financial barriers to accessing care, which is exacerbated by the SARS-CoV-2 coronavirus disease-19 pandemic. We identified knowledge gaps and next steps in improving T2DM care in rural areas. There is an urgent need for interventions tailored to rural areas given that rural Americans currently experience a disproportionate burden of T2DM and are encumbered by its associated morbidity, mortality, and loss in economic productivity.
AB - In the United States, rural areas have a higher burden of type 2 diabetes (T2DM) compared to urban areas. However, there is limited information on risk factors and interventions that improve the primary prevention and management of T2DM in rural areas. To synthesize current knowledge on T2DM in rural areas and to guide healthcare providers and policy makers, we reviewed five scientific databases and the grey literature over the last decade (2010–2020). We described classification systems for rurality and the T2DM burden based on rurality and region (West, South, Midwest, and Northeast). We highlighted risk factors for T2DM in rural compared to urban areas, and summarized interventions to screen and manage T2DM based on opportunistic screening, T2DM self-management, community-based initiatives, as well as interventions targeting comorbidities and T2DM. Several studies identified the co-existence of T2DM and depression/psychological symptoms, which could reduce adherence to non-pharmacologic and pharmacologic management of T2DM. We highlighted the role of technology in education and counselling of patients with geographic and financial barriers to accessing care, which is exacerbated by the SARS-CoV-2 coronavirus disease-19 pandemic. We identified knowledge gaps and next steps in improving T2DM care in rural areas. There is an urgent need for interventions tailored to rural areas given that rural Americans currently experience a disproportionate burden of T2DM and are encumbered by its associated morbidity, mortality, and loss in economic productivity.
KW - primary prevention
KW - rural health
KW - type 2 diabetes mellitus
KW - urban–rural disparities
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U2 - 10.1002/dmrr.3410
DO - 10.1002/dmrr.3410
M3 - Article
C2 - 33021052
AN - SCOPUS:85092098893
VL - 37
JO - Diabetes/Metabolism Research and Reviews
JF - Diabetes/Metabolism Research and Reviews
SN - 1520-7552
IS - 5
M1 - e3410
ER -