1. 189-LB: Household Food Insecurity and Associations with Glycemic Control and Acute Diabetes-Related Complications in Youth and Young Adults with Type 1 Diabetes: The SEARCH for Diabetes in Youth Study
- Author
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Dana Dabelea, Santica M. Marcovina, Deborah A. Bowlby, Catherine Pihoker, Jean M. Lawrence, Lauren A. Reid, Katherine A. Sauder, Faisal Malik, Angela D. Liese, Alice M. Ellyson, Sharon Saydah, Elizabeth T. Jensen, Jason A. Mendoza, and Edward A. Frongillo
- Subjects
Type 1 diabetes ,Pediatrics ,medicine.medical_specialty ,Diabetic ketoacidosis ,business.industry ,Endocrinology, Diabetes and Metabolism ,Psychological intervention ,Logistic regression ,medicine.disease ,Odds ,Diabetes mellitus ,Internal Medicine ,Medicine ,Young adult ,business ,Glycemic - Abstract
Objectives: To examine, among youth and young adults (YYAs) with type 1 diabetes (T1D), the independent association of household food insecurity (HFI) with: 1) glycemic control and 2) episodes of diabetic ketoacidosis (DKA) and severe hypoglycemia. Methods: This cross-sectional study included SEARCH for Diabetes in Youth participants with T1D examined between 2016-2019. HFI was assessed using the U.S. Household Food Security Survey Module. HbA1c was measured from blood drawn at a research visit; episodes of DKA and severe hypoglycemia were collected by survey. Linear and logistic regression models adjusted for age, sex, race, income, health insurance, diabetes duration, and SEARCH site. Results: Of 1834 participants (mean age 20.8±5.0 years, 69.9% non-Hispanic white, diabetes duration 11.1±3.2 years), HbA1c was collected for 1029 individuals (mean HbA1c 9.2%±2.0%). The prevalence of HFI was 16.4%. In this sample, 18.7% and 9.9% reported an episode of DKA or severe hypoglycemia in the past 12 months, respectively. Compared to participants who were food secure, HFI was associated with a 0.43% [CI: 0.02%-0.68%] higher HbA1c. In two separate adjusted models, those with HFI had 1.86 [CI: 1.03, 2.34] times the odds of an episode of DKA and 1.64 [CI: 1.03, 2.34] times the odds of an episode of severe hypoglycemia as those without HFI. Conclusions: HFI is independently associated with poor glycemic control and increased odds of diabetes-related complications in YYAs with T1D. Interventions to reduce HFI and studies to longitudinally examine its impact on glycemic control and complications are warranted. Disclosure F. Malik: None. A.D. Liese: None. A.M. Ellyson: None. L.A. Reid: None. K.A. Sauder: None. E.A. Frongillo: None. C. Pihoker: None. D. Dabelea: None. J.M. Lawrence: None. E.T. Jensen: None. S. Saydah: None. S.M. Marcovina: None. D. Bowlby: None. J.A. Mendoza: None. Funding Centers for Disease Control and Prevention (00097, DP-05-069, DP-10-001); National Institute of Diabetes and Digestive and Kidney Diseases (1UC4DK108173)
- Published
- 2020
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