Research Alert: June 6, 2023

Diabetes Prevalence and Monitoring in Nonmetropolitan and Metropolitan Areas Within a Commercially Insured U.S. Population

This study used medical claims information from the IBM (now Meritave) MarketScan Commercial Claims and Encounters data, for 2018-2020, to examine the prevalence of diabetes and to determine if patients with diabetes were more or less likely to receive hemoglobin A1c (HbA1c) screening. Researchers also examined the association between receipt of HbA1c testing in 2019 and diabetes-related health outcomes in 2020.

Key Findings:

• Compared to enrollees living in metropolitan areas, enrollees living in nonmetropolitan areas had 22% higher likelihood of having diabetes, even after controlling for factors like age and region.
• The prevalence of diabetes in 2019-2020 was 7.9% in nonmetropolitan areas and 6.2% in metropolitan areas.
• Annual HbA1c testing occurred for 85.1% of nonmetropolitan and 85.7% of metropolitan enrollees with diabetes. After controlling for other factors, testing was significantly lower for those in nonmetropolitan areas.
• For diabetic enrollees, having an HbA1c test in 2019 was associated with an 8% decrease in the likelihood of non-cardiovascular complications related to diabetes and a 6% decrease in the likelihood of inpatient diabetes care in 2020.
• Although most individuals in both metropolitan and nonmetropolitan communities received HbA1c testing, the odds of HbA1c testing were 14% lower for people living in nonmetropolitan areas. This suggests that there are gaps in preventative care and diabetes monitoring in nonmetropolitan communities.

Additional Resources of Interest:

• More information about the Rural and Underserved Health Research Center
• More information from the Rural Health Information Hub's topic guide: Chronic Disease