Food Insecurity is Associated with High Risk Glycemic Control and Higher Health Care Utilization among Youth and Young Adults with Type 1 Diabetes.
Diabetes research and clinical practice
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.
- 1Department of Pediatrics, University of Washington, Seattle, WA, USA; Seattle Children's Research Institute, Seattle, WA, USA; Health Disparities Research Center, Fred Hutchinson Cancer Research Center/UW Cancer Consortium, Seattle, WA, USA. Electronic address: firstname.lastname@example.org.
- 2Seattle Children's Research Institute, Seattle, WA, USA.
- 3Department of Biostatistical Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
- 4Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC, USA.
- 5Department of Pediatrics, University of Washington, Seattle, WA, USA; Seattle Children's Research Institute, Seattle, WA, USA.
- 6Health Promotion, Education and Behavior, University of South Carolina, Columbia, SC, USA.
- 7Departments of Nutrition and Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
- 8Department of Pediatrics, University of Washington, Seattle, WA, USA; Seattle Children's Research Institute, Seattle, WA, USA.
- 9Department of Epidemiology, Colorado School of Public Health, University of Colorado-Denver Anschutz Medical Center, Denver, CO, USA.
- 10Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA.
- 11Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC, USA; Center for Research in Nutrition and Health Disparities, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
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.
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.
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.
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||Last Modified: 2016-03-27