A study suggests that people with diabetes than diabetics living in more affluent areas. Communities with lower employment, income and education that have scant resources to support exercise and healthy eating have long been linked to an increased risk of developing diabetes. The study published in Diabetes Care.

For the current study, researchers focused on 15,308 patients who already had diabetes to see if their neighborhoods might impact how well they lived with the disease. Study found all the patients had poorly controlled diabetes, or a haemoglobin A1c level of at least 7.5. Over six months, reductions in A1c were 0.07% less in townships with the most socioeconomic deprivation than in the most affluent neighborhoods.

At the same time, A1c improvements were up to 0.19% greater in communities with the most exercise opportunities than in the places with the fewest resources for physical activity. A1c improvements were also 0.10% bigger in areas with the best food availability.

“People with type 2 diabetes do not live in their doctors’ offices, and most of the work they do to control their disease, such as eating a healthy diet, exercising, and taking their medications, happens in the communities in which they live,” said lead study author Annemarie Hirsch. “If communities do not offer healthy food options or safe places to exercise, it is going to be harder to manage type 2 diabetes,”

Hirsch said by email. “Living in neighborhoods with high unemployment and high poverty can also cause stress, and chronic stress has been associated with poorer (blood sugar) control in people with type 2 diabetes.” Globally, almost one in 10 adults has diabetes, according to the World Health Organization. Most of them have type 2 diabetes.

Patients in the current study were 58 years old on average, and most of them were white. Their initial haemoglobin A1c readings averaged 8.2. The influence of neighborhoods on A1c was more pronounced in smaller townships, and less apparent or non-existent in bigger cities.

The study wasn’t a controlled experiment designed to prove whether or how communities might impact blood sugar in people with diabetes. Another limitation is all the patients were treated at Geisinger, a health system based in Pennsylvania, and the results might be different elsewhere.

Hamad said, “That means the neighborhood isn’t causing their worse diabetes; they already were at risk because of personal characteristics.” Still, the findings add to the evidence that it can be much harder for patients in poor neighborhoods with limited resources to manage diabetes and other chronic diseases.

Author advices if the community is unsafe and there is no access to exercise facilities, walk at shopping malls, parks or public buildings. And for food, read labels and select the healthiest options.