Diabetes care among rural Americans.

The prevalence of diabetes in the United States is higher among those living in rural/ nonmetropolitan statistical areas than in urban centers. Managing this complex chronic illness is complicated by factors such as limited access to care, low socioeconomic status, aging, and membership in a racial or ethnic minority group. A review of the literature was conducted focusing on research about rural Americans with diabetes by searching databases of CINAHL, PubMed, and MEDLINE, and selecting articles in English that were published between 2000 and 2007. Search terms included: nursing, research, rural, rural nursing, rural health services/programs, and diabetes care. Additional search strategies included journal hand searching and networking. Twenty-six research reports were found and included qualitative and quantitative methods and program evaluations. All regions of the United States were represented except the Northwest. The vast majority of research reports were of descriptive studies (n = 16), with program evaluation reports (n = 7) and studies testing an intervention (n = 3) also represented. The quality of each study is examined and summarized.