Although it is hypothesized that rural American adults with diabetes (DM) have poorer control of ABCS risk factors [glycohemoglobin (A1c), Blood pressure (BP), Cholesterol, and Smoking], there are no empiric data comparing diabetes care in rural versus urban areas. We examined rural and urban differences in proportions of U.S. adults with DM achieving A1c <8.0%, BP <140/90 mmHg, non-HDL cholesterol <160 mg/dL, and current non-smoker, separately and combined. We analyzed data from 5,534 participants aged ≥18 years with diagnosed DM in the NHANES during 1999-2016. About 20% of U.S. adults with diagnosed DM reside in rural areas. ABCS goal achievement changes from 1999-2004 to 2011-2016 varied by urban/rural areas (see Table). Current non-smoker prevalence increased only for rural areas by 17 percentage points. Non-HDL cholesterol goal achievement increased by 17 percentage points in both rural and urban areas. In urban areas, achievement in BP and all ABCS goals increased by 8 and 15 percentage points, respectively. Although no significant difference was noted in achieving A1c goal from 1999-2004 to 2011-2016 in rural or urban areas, between 2005-2010 to 2011-2016, there was a decrease in A1c goal achievement in rural setting by 11 percentage points. Achievement of ABCS goals has generally improved among U.S. adults with DM, with about 1/3 of U.S. adults with DM achieving all four ABCS goals, regardless of rural/urban status.


C. Mercado: None. K.M. Bullard: None. M.K. Ali: None. G. Imperatore: None. S. Saydah: None. E. Gregg: None.

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