Type 2 Diabetes Management in Aotearoa New Zealand: A Comparison of Urban and Rural Primary Care Clinics.
Sara Mustafa, Mark Rodrigues, Ross Lawrenson and 10 others
PMID 41024742WHAT IT FOUND
Rural T2D clinics had similar HbA1c levels to urban clinics, but more rural patients lacked HbA1c and urine albumin tests, and rural patients were less often prescribed metformin, ACE inhibitors, or statins.
Key findings
01Rural clinics enrolled more Māori patients (31.4% vs urban 17.4%) and more patients in the most deprived areas (36.4% vs urban 31.4%).
02Rural patients had similar HbA1c values to urban patients (60.6 vs 61.6 mmol/mol) but were more likely to have no HbA1c test (11.0% vs urban 9.4%) and no urine albumin test (38.4% vs urban 25.5%).
03Rural patients had lower adjusted odds of receiving metformin (adjusted OR 0.687), ACE inhibitors (0.82), or statins (0.65) than urban patients.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Most patients were from urban clinics (85.3%), and the data came from Auckland and Waikato, so findings may not apply to all rural areas of New Zealand. The study classified rural status by the clinic where patients were enrolled, not where patients lived. It is an observational comparison of existing records, so it cannot show that rural location caused differences in testing or prescribing. The authors noted that differences in mean HbA1c between rural and urban patients were not clinically relevant, so small numerical differences should not be overread.
Declared interests
The authors declared no conflicts of interest. The study was funded by the Health Research Council of New Zealand.
The easy way to misread this
Do not read lower rural prescribing rates as proof that rural clinics provide worse care. The study only compared existing records and cannot show why testing or prescribing differed, and mean HbA1c was similar between rural and urban patients.