Related Experiment Video
Updated: Aug 8, 2026

Improving IV Insulin Administration in a Community Hospital
Published on: June 11, 2012
Driving distance as a barrier to glycemic control in diabetes
Kaitlin Strauss1, Charles MacLean, Austin Troy
1College of Medicine, University of Vermont, Burlington, VT 05401, USA. kstrauss@uvm.edu
Background:
Despite advances in treatment of diabetes, many barriers to good glycemic control remain.
Objective:
To determine the relationship between glycemic control and the driving distance from home to the site of primary care.
Design:
Cross-sectional analysis of data from the Vermont Diabetes Information System.
Participants:
Nine-hundred and seventy-three adults with diabetes in primary care. The mean age was 64.9 years, 57% were female, and 18.4% used insulin.
Measurements:
Hemoglobin A1c, shortest driving distance from a patient's home to the site of primary care calculated by geographic software, self-reported gender, age, education, income, marital status, race, insurance coverage, diabetic complications, and use of insulin and oral hypoglycemic agents.
Results:
Controlling for social, demographic, seasonal, and treatment variables, there was a positive, significant relationship between glycemic control and driving distance (beta=+0.07%/10 km, P<.001, 95% confidence interval [CI]=+0.03, +0.11). Driving distance had a stronger association with glycemic control among insulin users (beta=+0.22%/10 km, P=.016, 95% CI=+0.04, +0.40) than among noninsulin users (beta=+0.06%/10 km, P=.006, 95% CI=+0.02, +0.10).
Conclusion:
Longer driving distances from home to the site of primary care were associated with poorer glycemic control in this population of older, rural subjects. While the mechanism for this effect is not known, providers should be aware of this potential barrier to good glycemic control.
Related Concept Videos
Hyperglycemia
Diabetes Mellitus: Type 2 and Gestational
Diabetes: Management and Pharmacotherapy
Insulin remains the cornerstone of treatment for most patients with type 1 and many...
Diabetes: Symptoms, Diagnosis, and Complications
Type II Diabetes Mellitus III: Clinical Manifestations and Diagnosis
Diabetes Mellitus: Overview and Type I Subtype
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body is unable to produce sufficient insulin, and individuals with...
