{
  "abstract": "Objective To determine the proportion of Aboriginal and/or Torres Strait Islander Peoples with diabetes who were monitored according to recommended national guidelines and had their clinical parameters within recommended targets. We also examined trends over time (2013–2022) and compared urban and rural areas.Design A repeated cross-sectional study using data from a national general practice database (MedicineInsight, 2013–2022).Setting De-identified electronic health records (EHR) of people attending 427 mainstream general practices across Australia.Participants This study included all Aboriginal and/or Torres Strait Islander adults (18+ years) diagnosed with diabetes mellitus who were regular patients (attended at least once a year in three consecutive years) within the MedicineInsight database.Outcome measures Outcomes measured were (i) monitoring of blood glucose, lipids, blood pressure (BP), renal function and Body Mass Index (BMI)/waist circumference (WC) and (ii) achieving recommended targets: glycosylated haemoglobin (HbA1c) ≤7.0%, fasting glucose 4–7 mmol/L, random glucose 5–10 mmol/L, total cholesterol ≤4.0 mmol/L, low-density lipoprotein <2.0 mmol/L, BP ≤130/80 mmHg, estimated glomerular filtration rate >60 mL/min/1.73 m 2, urine albumin-creatinine ratio (uACR) <2.5 mg/mmol (men); <3.5 (women), BMI <25 kg/m2, WC <80 cm (men); <94 (women). Adjusted analyses explored trends and differences in outcomes according to practice remoteness using Australian Statistical Geography Standard (ASGS) classifications: major cities (ASGS-1), inner regional (ASGS-2) or rural/remote (ASGS3-5).Results Between 70% and 90% of individuals were monitored for the clinical parameters above, except for BMI/WC (55%–75%). Trends in monitoring over time were similar across remoteness areas, increasing slightly in 2013–2014 and declining from 2019. Among those monitored, 53%–86% achieved targets for blood glucose, lipids and renal function; 32%–42% for BP; and <10% had normal BMI/WC. In 2022, the proportion achieving targets was lower in rural than urban areas for blood glucose (68.4%, 95% CI: 60.8 to 75.9 vs 86.3%, 95% CI: 81.8 to 90.7) and lipids (61.3%, 95% CI: 54.1 to 68.5 vs 79.5%, 95% CI: 73.8 to 85.3).Conclusion The risk of diabetes complications among Aboriginal and/or Torres Strait Islander Peoples could be reduced by improving management of blood pressure and overweight/obesity in all areas, and blood glucose and lipids in rural areas.",
  "authors": [
    {
      "affiliations": [
        "The University of Adelaide Rural Clinical School, Adelaide, South Australia, Australia"
      ],
      "name": "Antoinette Liddell"
    },
    {
      "affiliations": [
        "The University of Adelaide Rural Clinical School, Adelaide, South Australia, Australia",
        "The University of Adelaide Discipline of General Practice, Adelaide, South Australia, Australia"
      ],
      "name": "Natalie Pink"
    },
    {
      "affiliations": [
        "The University of Adelaide Rural Clinical School, Adelaide, South Australia, Australia",
        "The University of Adelaide Discipline of General Practice, Adelaide, South Australia, Australia"
      ],
      "name": "Fernanda Baldim Jardim Nobre"
    },
    {
      "affiliations": [
        "The University of Adelaide Discipline of General Practice, Adelaide, South Australia, Australia"
      ],
      "name": "Carla Bernardo"
    },
    {
      "affiliations": [
        "The University of Adelaide Rural Clinical School, Adelaide, South Australia, Australia"
      ],
      "name": "Susan Williams"
    },
    {
      "affiliations": [
        "The University of Adelaide Discipline of General Practice, Adelaide, South Australia, Australia"
      ],
      "name": "Nigel Stocks"
    },
    {
      "affiliations": [
        "The University of Adelaide Rural Clinical School, Adelaide, South Australia, Australia",
        "The University of Adelaide Discipline of General Practice, Adelaide, South Australia, Australia"
      ],
      "name": "David Gonzalez-Chica"
    }
  ],
  "title": "Trends in diabetes monitoring and control among Aboriginal and Torres Strait Islander Peoples attending general practice in urban and rural locations in Australia: a repeated cross-sectional study using data from a national general practice database (MedicineInsight)",
  "uid": "707dffc2-a802-50ec-b609-a4b08736ce4d"
}