Food Insecurity is Associated with Hypoglycemia and Poor Diabetes Self-Management in a Low-Income Sample with Diabetes
Food Insecurity is Associated with Hypoglycemia and Poor Diabetes Self-Management in a Low-Income Sample with Diabetes
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DOI：
10.1353/hpu.2010.0921
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发表时间：
2010-11-01
影响因子：
1.4
通讯作者：
Wolf, Michael S.
中科院分区：
文献类型：
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作者：
Seligman, Hilary K.;Davis, Terry C.;Wolf, Michael S.
超过14%的美国人粮食不安全，或者因为买不起食物而面临饥饿的风险。食物不安全（FI）的成年人经常减少食物摄入量，或用便宜的、能量密集的碳水化合物代替更健康的食物。我们假设这些行为会使患有糖尿病的FI成年人容易发生低血糖和糖尿病自我管理受损。因此，我们在40名低收入糖尿病成人患者中评估了食物不安全是否与糖尿病自我管理的多个指标（自我效能、药物和血糖监测依从性、低血糖或血糖控制）相关。FI参与者的平均自我效能评分低于食品安全（FS）参与者（34.4 vs. 41.2，p= 0.02）。食物不安全的参与者报告血糖监测的依从性较差（RR=3.5，p= 0.008），低血糖相关的急诊就诊次数更多（RR=2.2，p= 0.007）。平均血红蛋白A1c在FI中为9.2%，在FS参与者中为7.7%（p= 0.08）。食物不安全是糖尿病自我管理的障碍，也是临床显著低血糖的风险因素。
More than 14% of the American population is food insecure, or at risk of going hungry because of an inability to afford food. Food-insecure (FI) adults often reduce food intake or substitute inexpensive, energy-dense carbohydrates for healthier foods. We hypothesized these behaviors would predispose FI adults with diabetes to hypoglycemia and impaired diabetes self-management. We therefore assessed whether food insecurity was associated with multiple indicators of diabetes self-management (self-efficacy, medication- and glucose-monitoring adherence, hypoglycemia, or glycemic control) among 40 low-income adults with diabetes. Mean self-efficacy score was lower among FI than food-secure (FS) participants (34.4 vs. 41.2, p=.02). Food-insecure participants reported poorer adherence to blood glucose monitoring (RR=3.5, p=.008) and more hypoglycemia-related emergency department visits (RR=2.2, p=.007). Mean hemoglobin A1c was 9.2% among FI and 7.7% among FS participants (p=.08). Food insecurity is a barrier to diabetes self-management and a risk factor for clinically significant hypoglycemia.