Type 1 diabetes mellitus in the rural United States: a scoping review of definitions, healthcare delivery, and patient outcomes.
Abstract
Aims
Those living in rural communities with type 1 diabetes mellitus (T1DM) may experience health disparities due to geographic isolation from specialized medical care. The purpose of this scoping review was to synthesize the existing evidence on how the rural context influences access to, quality of, and health outcomes for those living with T1DM.
Methods
We searched PubMed, Scopus, Embase, Cumulative Index to Nursing and Allied Health (CINAHL), and PsycInfo from 2020 to 2023 for rural, type 1 diabetes mellitus, peer-reviewed literature, which produced 5,551 studies. After duplication removal, we screened 3,807 titles and abstracts and reviewed 194 full-text articles. We synthesized 21 articles that met criteria for rurality and patient health outcomes.
Results
Themes from the review included: a need for a clear definition of rural as it relates to T1DM health; inadequacy of rural healthcare and resources; technology counters the inadequacy of existing healthcare infrastructure; psychosocial resilience; and contextual influences of T1DM health.
Conclusion
Findings suggest that although those living with T1DM in rural communities display resilience and embrace technological advances, there is a critical need for T1DM research to include rural communities, clearly define the nature of rurality, and develop and evaluate the effectiveness of tailored healthcare interventions aimed at improving rural patient health outcomes.