Diabetes risk factors, diabetes and diabetes care in a rural Australian community.
OBJECTIVE
To comprehensively describe diabetes-related risk factors, quality of care and patient-perceived barriers to care in a rural community.


METHODS
Cross-sectional mail study, self-completed survey and retrospective chart review.


METHODS
Community and health services in Corryong, rural Victoria, Australia.


METHODS
Ninety-seven patients with diabetes and 495 with other diseases in the mail study, 84 with diabetes in the self-completed survey and 101 diabetic patient chart reviews.


METHODS
Self-reported lifestyle activities, uptake of health checks, metabolic measures and uptake of medication, and self-reported barriers to diabetes care.


RESULTS
Most residents without diabetes had recently had their blood pressure and cholesterol checked; 60.4% were trying to control their weight and 73.9% were exercising regularly (although only 30.7% to an adequate level). Those with diabetes reported a greater uptake of healthy living messages, and had a mean HbA1c of 7.3%, total cholesterol of 5.0 mmol L(-1); 12.9% had a diastolic blood pressure > or =85 mmHg. Foot checks were infrequent (18%). There was substantial room to increase antiplatelet, blood pressure, antihyperglycaemia and lipid-lowering therapy. Most patients reported psychological (84.5%) and educational (82.1%) barriers to care, with few perceiving physical barriers to care.


CONCLUSIONS
Living in a rural area with predominantly GP care can be associated with comparatively good metabolic control, although psycho-educational barriers are frequently present. In the wider community, risk factors for diabetes remain common, and the majority have been screened for components of the metabolic syndrome in the previous year.
Simmons
David
D
Department of Diabetes, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK. dsworkster@gmail.com
Bourke
Lisa
L
Yau
Edward
E
Hoodless
Mary
M
D000368:Aged; D000704:Analysis of Variance; D001294:Attitude to Health; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000523:psychology / Q000628:therapy; D005194:Family Practice / Q000458:organization & administration; D005260:Female; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility / Q000458:organization & administration*; D006801:Humans; D008019:Life Style; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D020380:Needs Assessment; D010353:Patient Education as Topic / Q000458:organization & administration; D011787:Quality of Health Care / Q000592:standards*; D012189:Retrospective Studies; D012307:Risk Factors; D019035:Rural Health Services / Q000458:organization & administration*; D012944:Social Support; D011795:Surveys and Questionnaires; D014739:Victoria / Q000453:epidemiology