• Yeong Jun Ju, Woorim Kim, Kyujin Chang, Tae Hoon Lee, and Soon Young Lee.
• Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon-si, Gyeonggi-do, Republic of Korea.
• Prev Med. 2024 Jan 1; 178: 107793107793.

ObjectiveMany municipal districts in Korea face population decline owing to overall population decreases and aging. We investigated the association between geographic rurality and likelihood of receiving diabetes management education and diabetic retinopathy and diabetes-related kidney disease screenings among adults with diabetes.MethodsPatient data were obtained from the 2021 Korea Community Health Survey (27,391 individuals; aged ≥19 years and physician-diagnosed with diabetes mellitus). Geographic rurality was categorized based on population decline as follows: with, at risk of, or without population decline. The association between geographic rurality and likelihood of receiving diabetes management education and diabetic retinopathy and diabetes-related kidney disease screenings was examined using multilevel logistic regression analyses.ResultsAmong 27,391 patients with diabetes, 31.1% received diabetes education; 40.0% and 46.4% were screened for diabetic retinopathy and diabetes-related kidney disease, respectively. Individuals residing in regions with population decline were less likely to receive diabetes education (odds ratio [OR] 0.62, 95% CI 0.50-0.75) and diabetic retinopathy (OR 0.79, 95% CI 0.70-0.90) and diabetes-related kidney disease (OR 0.64, 95% CI 0.55-0.75) screenings, as compared with their counterparts.ConclusionsOur findings highlight the importance of increased monitoring and providing diabetes education and screenings for patients with diabetes living in rural areas.Copyright © 2023 Elsevier Inc. All rights reserved.

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