A comparison of diabetes care in rural and urban medical clinics in Alabama

J Community Health. 2004 Feb;29(1):29-44. doi: 10.1023/b:johe.0000007443.96138.03.


This study sought to determine the differences in the level of diabetes care of patients in a rural family practice clinic and an urban internal medicine clinic in Alabama. Medical records of patients with diabetes were reviewed and management practices were compared to current American Diabetes Association (ADA) standards of care. The rural practice had fewer patients at goal A1c, goal LDL, and goal blood pressure. Rural patients were also less likely to receive screening and preventative services such as lipid profiles, eye examinations, microalbumin screening, aspirin therapy, and vaccinations than urban patients. Although, adherence to the ADA standards of care was lower with rural patients, the results suggest that there exists significant opportunity to improve the delivery of diabetes care services to both patient populations.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Alabama
  • Blood Pressure
  • Diabetes Complications
  • Diabetes Mellitus / blood
  • Diabetes Mellitus / therapy*
  • Female
  • Glycated Hemoglobin / analysis
  • Humans
  • Hyperlipidemias / blood
  • Male
  • Middle Aged
  • Patient Compliance / statistics & numerical data
  • Practice Guidelines as Topic
  • Practice Patterns, Physicians' / standards
  • Primary Health Care / standards*
  • Quality Indicators, Health Care*
  • Rural Health Services / standards*
  • Societies, Medical
  • Urban Health Services / standards*


  • Glycated Hemoglobin A