Food insecurity is associated with diabetes self-care behaviours and glycaemic control.
Food insecurity is associated with diabetes self-care behaviours and glycaemic control.
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DOI：
10.1111/dme.12896
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发表时间：
2016-06
期刊：
影响因子：
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通讯作者：
Rothman RL
中科院分区：
文献类型：
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作者：
Heerman WJ;Wallston KA;Osborn CY;Bian A;Schlundt DG;Barto SD;Rothman RL
粮食不安全是指“营养充足且安全的食品供应有限或不确定”。我们的目标是研究食品不安全、糖尿病自我护理和血糖控制之间的关联。我们对参加一项随机试验的 2 型糖尿病成年患者的基线数据进行了横断面分析，该试验评估了田纳西州中部安全网初级保健诊所以健康素养为重点的糖尿病干预措施。粮食不安全是根据美国家庭粮食安全调查的三个项目进行评估的。通过糖尿病自我护理活动总结量表、个人糖尿病问卷以及续药和药物依从性量表评估糖尿病自我护理行为。通过 HbA1c 评估血糖控制。该样本由 401 名参与者组成，其中 73% 的人表示存在一定程度的粮食不安全状况。食物不安全与自我护理行为显着相关，包括对一般饮食的依从性较低（AOR 0.9，P = 0.02）、体力活动较少（AOR 0.9，P = 0.04）以及不依从药物治疗（AOR 1.2，P = 0.002）和热量限制（AOR 1.1，P = 0.02）的发生率较高。食物不安全也与较差的血糖控制有关（调整后的β = 0.1，P = 0.03）。没有一种自我保健行为与 HbA1c 显着相关，限制了测试自我保健作为将食品不安全与血糖控制联系起来的机制的能力。在社会经济地位较低的 2 型糖尿病患者样本中，粮食不安全的比例很高。食物不安全与对推荐的自我护理行为的遵守程度较低和血糖控制较差有关。
Food insecurity is the ‘limited or uncertain availability of nutritionally adequate and safe foods’. Our objective was to examine the association between food insecurity, diabetes self-care and glycaemic control. We conducted a cross-sectional analysis of baseline data from adult patients with Type 2 diabetes who were enrolled in a randomized trial evaluating a health literacy-focused diabetes intervention in safety net primary care clinics in middle Tennessee. Food insecurity was assessed with three items from the U.S. Household Food Security Survey. Diabetes self-care behaviours were assessed with the Summary of Diabetes Self-Care Activities Scale, Personal Diabetes Questionnaire and Adherence to Refills and Medication Scale. Glycaemic control was assessed with HbA1c. The sample consisted of 401 participants, 73% of whom reported some level of food insecurity. Food insecurity was significantly associated with self-care behaviours including less adherence to a general diet (AOR 0.9, P = 0.02), less physical activity (AOR 0.9, P = 0.04) and with a greater occurrence of medication non-adherence (AOR 1.2, P = 0.002) and calorie restriction (AOR 1.1, P = 0.02). Food insecurity was also associated with worse glycaemic control (adjusted β = 0.1, P = 0.03). None of the self-care behaviours were significantly associated with HbA1c, limiting the ability to test for self-care as a mechanism linking food insecurity to glycaemic control. There was a high rate of food insecurity in a sample of patients with Type 2 diabetes who were of low socio-economic status. Food insecurity was associated with less adherence to recommended self-care behaviours and worse glycaemic control.