Study of Diabetes Care in Urban and Rural Diabetics

Abstract

BACKGROUND: The proportion of diabetes is increasing in rural areas due to rapid urbanization and change in life style occurring in these areas. The knowledge about difference in risk factors, prevalence of complications, glycemic outcome in rural and urban diabetics helps in better management and prevention of early complications. AIMS AND OBJECTIVES: To study and compare the clinical profile and glycemic outcome in diabetic cases from urban and rural areas. METHODOLOGY: Details were collected from 100 diabetic patients (50 urban and 50 rural) attending R. L. Jalappa Hospital outpatient department. Detailed history was taken and physical examination was done. History of complications were noted. Clinical profile, prevalence of complications, glycemic outcome were studied and compared between patients form urban and rural areas. RESULTS: In the study 100 diabetics [50 from urban and 50 from rural] were studied and there was no significant difference between urban and rural diabetics with respect to age, duration of diabetes, BMI, Waist circumference, blood pressure. Hence the study population is matched and comparable. In this study the prevalence of complications was higher in both rural diabetics (78%) and urban diabetic subjects (64%). But there was no statistical significance between complications and the location of the subjects. In urban diabetics, the most common complication in decreasing order was retinopathy (56%), neuropathy (32%), nephropathy (20%) and IHD (12%). Whereas most common complication in rural diabetics were retinopathy (46%), neuropathy (26%), IHD (24%) and nephropathy (20%). Most of the diabetics in both rural (72%) and urban (62%) areas were not screened for associated complications. CONCLUSIONS: There was no much difference in glycemic outcome and prevalence of all complications between urban and rural study groups. Both urban and rural diabetics did not have optimal glycemic control. This may be due to the low rates of awareness of diabetes and its complications in both rural and urban subjects.