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Does the shortage of diabetes specialists in regional and rural Australia matter? Results from Diabetes MILES-Australia


Skinner, T and Allen, P and Peach, E and Browne, JL and Pouwer, F and Speight, J and Dunbar, JA, Does the shortage of diabetes specialists in regional and rural Australia matter? Results from Diabetes MILES-Australia, Diabetes Research and Clinical Practice, 100, (2) pp. 222-229. ISSN 0168-8227 (2013) [Refereed Article]

Copyright Statement

Crown Copyright 2013

DOI: doi:10.1016/j.diabres.2013.03.015


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.

Item Details

Item Type:Refereed Article
Keywords:Diabetes management, health indicators, rural, access to healthcare
Research Division:Biomedical and Clinical Sciences
Research Group:Clinical sciences
Research Field:Endocrinology
Objective Division:Health
Objective Group:Clinical health
Objective Field:Clinical health not elsewhere classified
UTAS Author:Skinner, T (Professor Timothy Skinner)
UTAS Author:Allen, P (Dr Penny Allen)
ID Code:86591
Year Published:2013
Web of Science® Times Cited:13
Deposited By:Rural Clinical School
Deposited On:2013-09-30
Last Modified:2015-03-05

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