Format

Send to

Choose Destination
See comment in PubMed Commons below
J Gen Intern Med. 2006 Apr;21(4):378-80.

Driving distance as a barrier to glycemic control in diabetes.

Author information

1
College of Medicine, University of Vermont, Burlington, VT 05401, USA. kstrauss@uvm.edu

Abstract

BACKGROUND:

Despite advances in treatment of diabetes, many barriers to good glycemic control remain.

OBJECTIVE:

To determine the relationship between glycemic control and the driving distance from home to the site of primary care.

DESIGN:

Cross-sectional analysis of data from the Vermont Diabetes Information System.

PARTICIPANTS:

Nine-hundred and seventy-three adults with diabetes in primary care. The mean age was 64.9 years, 57% were female, and 18.4% used insulin.

MEASUREMENTS:

Hemoglobin A1c, shortest driving distance from a patient's home to the site of primary care calculated by geographic software, self-reported gender, age, education, income, marital status, race, insurance coverage, diabetic complications, and use of insulin and oral hypoglycemic agents.

RESULTS:

Controlling for social, demographic, seasonal, and treatment variables, there was a positive, significant relationship between glycemic control and driving distance (beta=+0.07%/10 km, P<.001, 95% confidence interval [CI]=+0.03, +0.11). Driving distance had a stronger association with glycemic control among insulin users (beta=+0.22%/10 km, P=.016, 95% CI=+0.04, +0.40) than among noninsulin users (beta=+0.06%/10 km, P=.006, 95% CI=+0.02, +0.10).

CONCLUSION:

Longer driving distances from home to the site of primary care were associated with poorer glycemic control in this population of older, rural subjects. While the mechanism for this effect is not known, providers should be aware of this potential barrier to good glycemic control.

Comment in

PMID:
16686817
PMCID:
PMC1484707
DOI:
10.1111/j.1525-1497.2006.00386.x
[Indexed for MEDLINE]
Free PMC Article
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for PubMed Central
    Loading ...
    Support Center