Food Insecurity is Associated with High Risk Glycemic Control and Higher Health Care Utilization among Youth and Young Adults with Type 1 Diabetes

Details

• Alternative Title:
  Diabetes Res Clin Pract
• Personal Author:
  Mendoza, Jason A. ; Haaland, Wren ; D’Agostino, Ralph B. ; Martini, Lauren ; Pihoker, Catherine ; Frongillo, Edward A. ; Mayer-Davis, Elizabeth J. ; Liu, Lenna L. ; Dabelea, Dana ; Lawrence, Jean M. ; Liese, Angela D.
• Description:
  Aims
  
  Household food insecurity (FI), i.e., limited availability of nutritionally adequate foods, is associated with poor glycemic control among adults with type 2 diabetes. We evaluated the association of FI among youth and young adults (YYA) with type 1 diabetes to inform recent clinical recommendations from the American Diabetes Association for providers to screen all patients with diabetes for FI.
  
  Methods
  
  Using data from the Washington and South Carolina SEARCH for Diabetes in Youth Study sites, we conducted an observational, cross-sectional evaluation of associations between FI and glycemic control, hospitalizations, and emergency department (ED) visits among YYA with type 1 diabetes. FI was assessed using the Household Food Security Survey Module, which queries conditions and behaviors typical of households unable to meet basic food needs. Participants’ HbA1c were measured from blood drawn at the research visit; socio-demographics and medical history were collected by survey.
  
  Results
  
  The prevalence of FI was 19.5%. In adjusted logistic regression analysis, YYAs from food-insecure households had 2.37 higher odds (95% CI: 1.10, 5.09) of high risk glycemic control, i.e., HbA1c >9.0%, vs. peers from food-secure households. In adjusted binomial regression analysis for ED visits, YYAs from food-insecure households had an adjusted prevalence rate that was 2.95 times (95% CI [1.17, 7.45]) as great as those from food secure households.
  
  Conclusions
  
  FI was associated with high risk glycemic control and more ED visits. Targeted efforts should be developed and tested to alleviate FI among YYA with type 1 diabetes.
  
  
• Subjects:
  Adolescent Cross-Sectional Studies Diabetes Mellitus, Type 1 Female Food Supply Humans Hyperglycemia Male Patient Acceptance Of Health Care Risk
• Keywords:
  Emergency Department Hospitalizations Pediatric Social Determinants Of Health
• Source:
  Diabetes Res Clin Pract. 138:128-137
• Pubmed ID:
  29427695
• Pubmed Central ID:
  PMC5910177
• Document Type:
  Journal Article
• Funding:
  P30 DK057516/DK/NIDDK NIH HHSUnited States/ ; UC4 DK108173/DK/NIDDK NIH HHSUnited States/ ; U18 DP002710/DP/NCCDPHP CDC HHSUnited States/ ; U18 DP006134/DP/NCCDPHP CDC HHSUnited States/ ; U18 DP006138/DP/NCCDPHP CDC HHSUnited States/ ; UL1 TR000154/TR/NCATS NIH HHSUnited States/ ; U18 DP002714/DP/NCCDPHP CDC HHSUnited States/ ; U01 DP000248/DP/NCCDPHP CDC HHSUnited States/ ; U01 DP000244/DP/NCCDPHP CDC HHSUnited States/ ; EP-C-15-002/EPA/EPAUnited States/ ; P30 DK056350/DK/NIDDK NIH HHSUnited States/ ; U18 DP006139/DP/NCCDPHP CDC HHSUnited States/ ; UL1 TR000423/TR/NCATS NIH HHSUnited States/ ; U01 DP000250/DP/NCCDPHP CDC HHSUnited States/ ; U18 DP002708/DP/NCCDPHP CDC HHSUnited States/ ; P30 DK017047/DK/NIDDK NIH HHSUnited States/ ; U01 DP000247/DP/NCCDPHP CDC HHSUnited States/ ; U18 DP006131/DP/NCCDPHP CDC HHSUnited States/ ; U18 DP006136/DP/NCCDPHP CDC HHSUnited States/ ; U18 DP002709/DP/NCCDPHP CDC HHSUnited States/ ; U18 DP006133/DP/NCCDPHP CDC HHSUnited States/ ; T32 GM081740/GM/NIGMS NIH HHSUnited States/ ; UL1 TR001425/TR/NCATS NIH HHSUnited States/ ; UL1 TR002319/TR/NCATS NIH HHSUnited States/ ; U01 DP000246/DP/NCCDPHP CDC HHSUnited States/ ; UL1 TR001450/TR/NCATS NIH HHSUnited States/ ; U01 DP000254/DP/NCCDPHP CDC HHSUnited States/
• Volume:
  138
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:6ed2cc3bdc17d17ee3b965877b3df7c571b07a01e0ae17d6af7455f86c9da2d32363c9b553b68714964d6b0836fd1cc74d8beb5be7b50a477c9e33c07e98e121
• Download URL:
  https://stacks.cdc.gov/view/cdc/53618/cdc_53618_DS1.pdf
• File Type:
  [PDF - 351.18 KB ]