The association between medical accessibility and glycemic status in patients with type 2 diabetes mellitus: A retrospective study in Taiwan rural population

Abstract

Introduction Type 2 diabetes mellitus represents a significant chronic health concern, with rural populations being particularly vulnerable due to geographic and socio-economic barriers to healthcare access. To date, few studies have focused on the medical accessibility of rural diabetic patients in Taiwan. This study aims to explore the association between the proximity to healthcare facilities and glycohemoglobin levels in the rural Taiwanese population. Methods We conducted a retrospective cross-sectional study in rural districts of southern Taiwan. Medical accessibility was calculated from subject’s address to medical units by Google Maps platform. Spearman's Rank Analysis was performed for the correlation between distance from patient’s address to medical units and glycohemoglobin level. Logistic regression was applied to identify factors associated with glycemic control. Results In total, 117 patients with type 2 diabetes mellitus were enrolled (mean glycohemoglobin: 8.17±1.92%). Glycohemoglobin level was modestly and positively associated with distance to clinic (Rho: 0.252) and hospital (Rho: 0.241) respectively. In logistic regression analysis, good glycemic control (glycohemoglobin less than 7%) was associated with covariates as not-working status, the address district near downtown, fasting plasma glucose equal to or less than 130 mg/dL, and normal high-density lipoprotein cholesterol level. Conclusion Our study reveals that accessibility to healthcare facility is modestly correlated with long-term glycemic status in Taiwan rural diabetic population. Besides, we also identified several protective factors associated with chronic glycemic status. These findings may pave the way for improvement of policy and healthcare strategies in rural diabetic care.