Highlights
- •Youth and adults with T1D had higher food insecurity than the national population.
- •Food insecurity was associated with high risk glycemic control.
- •Food insecurity was associated with more emergency department visits.
- •Programs are needed to alleviate food insecurity among youth and adults with T1D.
Abstract
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.
Keywords
Abbreviations:
ADA (American Diabetes Association), ED (Emergency department), HFSSM (Household Food Security Survey Module), FI (Household food insecurity), ISPAD (International Society for Pediatric and Adolescent Diabetes), MDI (Multiple daily injections), PR (Prevalence ratio), SES (Socioeconomic status), SEARCH (SEARCH for Diabetes in Youth Study), SC (South Carolina), USDA (United States Department of Agriculture), WA (Washington State), YYA (Youth and young adults)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: February 07, 2018
Accepted:
January 30,
2018
Received in revised form:
January 13,
2018
Received:
November 17,
2017
Identification
Copyright
© 2018 Elsevier B.V. All rights reserved.
