Household Food Insecurity is Associated with Diabetic Ketoacidosis but not Severe Hypoglycemia or Glycemic Control in Youth and Young Adults with Youth-Onset Type 2 Diabetes

Details

• Alternative Title:
  Pediatr Diabetes
• Personal Author:
  Reid, Lauren A. ; Mendoza, Jason A. ; Merchant, Anwar T. ; Geraci, Marco ; Reboussin, Beth A. ; Malik, Faisal S. ; Ellyson, Alice M. ; Dabelea, Dana ; Merjaneh, Lina ; Marcovina, Santica M. ; Lustigova, Eva ; Lawrence, Jean M. ; Liese, Angela D.
• Description:
  Objective:
  
  To examine the association between household food insecurity (HFI), glycemic control, severe hypoglycemia and diabetic ketoacidosis (DKA) among youth and young adults (YYA) with youth-onset type 2 diabetes.
  
  Research design and methods:
  
  This cross-sectional study included 395 YYA with type 2 diabetes from the SEARCH for Diabetes in Youth Study (2015-2019). HFI was reported by young adult participants or parents of minor participants via the US Household Food Security Survey Module. Glycemic control was assessed by HbA1c and analyzed as a continuous and categorical variable (optimal: <7.0%, suboptimal: ≥7.0%-9.0%, poor: >9.0%). Acute complications included self-reported severe hypoglycemia or DKA in the last 12 months. Adjusted logistic and linear regression were used for binary and continuous outcomes, respectively.
  
  Results:
  
  Approximately 31% reported HFI in the past 12 months. Mean HbA1c among those with HFI was 9.2% compared to 9.5% without HFI. Of those with HFI, 56% had an HbA1c > 9.0% compared to 55% without HFI. Adjusted models showed no associations between HFI and glycemic control. Of those with HFI, 14.4% reported experiencing DKA and 4.7% reported severe hypoglycemia. YYA with HFI had 3.08 times (95% CI: 1.18-8.06) the odds of experiencing DKA as those without HFI. There was no association between HFI and severe hypoglycemia.
  
  Conclusions:
  
  HFI was associated with markedly increased odds of DKA but not with glycemic control or severe hypoglycemia. Future research among YYA with type 2 diabetes should evaluate longitudinally whether alleviating HFI reduces DKA.
  
  
• Keywords:
  Adolescent Cross-Sectional Studies Diabetes Mellitus, Type 1 Diabetes Mellitus, Type 2 Diabetic Ketoacidosis Food Insecurity Glycated Hemoglobin Glycemic Control Humans Hypoglycemia Type 2 Diabetes Young Adult

  More +
• Source:
  Pediatr Diabetes. 23(7):982-990
• Pubmed ID:
  35752872
• Pubmed Central ID:
  PMC9588511
• Document Type:
  Journal Article
• Funding:
  P30 DK057516/DK/NIDDK NIH HHSUnited States/ ; U18 DP006131/DP/NCCDPHP CDC HHSUnited States/ ; U18 DP006134/DP/NCCDPHP CDC HHSUnited States/ ; U18 DP006138/DP/NCCDPHP CDC HHSUnited States/ ; U18DP006138/ACL/ACL HHSUnited States/ ; UL1 TR000154/TR/NCATS NIH HHSUnited States/ ; UL1 TR000062/TR/NCATS NIH HHSUnited States/ ; U18DP006134/ACL/ACL HHSUnited States/ ; UL1 TR001425/TR/NCATS NIH HHSUnited States/ ; U18DP006136/ACL/ACL HHSUnited States/ ; U18DP006133/ACL/ACL HHSUnited States/ ; U18DP006139/ACL/ACL HHSUnited States/ ; UL1 TR001450/TR/NCATS NIH HHSUnited States/ ; UC4 DK108173/DK/NIDDK NIH HHSUnited States/ ; U18 DP006136/DP/NCCDPHP CDC HHSUnited States/ ; U18 DP006133/DP/NCCDPHP CDC HHSUnited States/ ; R01 DK117461/DK/NIDDK NIH HHSUnited States/ ; U18DP006131/ACL/ACL HHSUnited States/ ; U18 DP006139/DP/NCCDPHP CDC HHSUnited States/ ; UL1 TR000077/TR/NCATS NIH HHSUnited States/ ; R01 DK127208/DK/NIDDK NIH HHSUnited States/ ; UL1 TR000423/TR/NCATS NIH HHSUnited States/
• Volume:
  23
• Issue:
  7
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:9c4ad6deb9cd3a585662a297626bf202d738daf8097abaeb619b98f5c986e752
• Download URL:
  https://stacks.cdc.gov/view/cdc/121912/cdc_121912_DS1.pdf
• File Type:
  [PDF - 102.33 KB ]