The risk of diabetes is higher in urban parts of England than in rural areas, a recent paper shows.
Researchers from NIHR ARC-GM and The University of Manchester have identified that people living in built-up parts of England are more at risk of diabetes when compared with those living in the countryside.
A recent paper in BMJ Open, published as part of the Cities Changing Diabetes (CCD) programme for Greater Manchester, a joint working project that was funded and developed by Health Innovation Manchester and Novo Nordisk. This compared the prevalence, diagnosis, quality of care and achievement of recommended treatment targets for people with diabetes in different areas in England between 2015 and 2017 to identify gaps in the appropriate identification, management, and treatment of diabetes along the care pathway.
Diabetes risk was 7.7% higher for people living in urban parts of England when compared with those living in rural areas. A smaller proportion of those who have diabetes and live in urban areas were found to have a diagnosis recorded by a medical professional, compared with rural areas.
A smaller proportion of urban residing people with a recorded diabetes diagnosis received the appropriate care and achieve recommended treatment targets including blood pressure and blood glucose levels. However, further analyses of differences in appropriate care provided by GPs in urban and rural areas showed that they did not persist after accounting for both the differences in these populations’ characteristics such as age, ethnicity and deprivation; but also the differences in the number of nurses and GPs per patient in these areas.
Dr Tom Mason, Research Fellow in Economics at The University of Manchester and NIHR ARC-GM Evaluation Team, led the analysis.
“These results for England are consistent with international evidence on urban patterns of diabetes prevalence, diagnosis and treatment. But we also wanted to explore potential factors that explain these differences in the patterns across the care pathway in urban and rural areas.
Our analyses showed that differences between urban and rural areas in care quality and treatment targets do not persist after accounting for differences in the profile of the populations living in these areas, and importantly after accounting for differences in the workforce resources allocated to urban and rurally located general practices.
These have implications for policymakers both in terms of the appropriate targeting of public health interventions and type 2 diabetes prevention, and in ensuring that differences in the need for diabetes care is appropriately reflected when allocating resources for general practices in urban areas.”
For further information about our work as part of the Cities Changing Diabetes Manchester Programme, you can access the project page from here; you can access the Cities Changing Diabetes Manchester ‘Mapping the challenge of type 2 diabetes in Greater Manchester’ report, and the ‘Estimating the Rule of Halves in Greater Manchester’ report
The published study: Mason T, Whittaker W, Dumville J & Bower P., 2022. Variation in appropriate diabetes care and treatment targets in urban and rural areas in England: an observational study of the ‘rule of halves’ BMJ Open
*Funded by the Cities Changing Diabetes Manchester programme, a joint working project funded by and developed in collaboration between Health Innovation Manchester and Novo Nordisk. The Cities Changing Diabetes Manchester project is part of the wider global Cities Changing Diabetes programme founded in 2014 by Novo Nordisk, University College London (UCL) and Steno Diabetes Center.