Aims

Investigate the relationship between food insecurity and glycemic control in adults with diagnosed and undiagnosed diabetes.

Methods

Using National Health and Nutrition Examination Survey (NHANES) between 2003–2016, food insecurity was measured using the household food insecurity scale. Glycemic control was measured using glycated hemoglobin (HbA1c) collected during the NHANES examination. Individuals were categorized into undiagnosed diabetes or diagnosed diabetes based on their measured HbA1c and response to whether they were told by a doctor or other health professional they have diabetes or were taking medications for diabetes. Sampling weights and survey procedures were used when conducting univariate and multivariable models using SAS version 9.4.

Results

Approximately 13.7% of the population sample (35,216 adults representing 207,271,917 US adults) reported food insecurity. Reporting food insecurity was associated with 0.37 higher HbA1c for diagnosed (95% CI 0.15−0.60) and 0.45 higher HbA1c for undiagnosed diabetes (95% CI 0.05−0.85). In the undiagnosed diabetes population, those reporting food insecurity had 80% higher likelihood of HbA1c above 7% (OR = 1.80, 95% CI 1.06–3.06).

Conclusions

Food insecurity had a stronger relationship with HbA1c for those with undiagnosed diabetes. Results suggest the importance of screening for individuals with food insecurity that may be at high risk for having undiagnosed diabetes.

中文翻译：

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美国已确诊和未确诊糖尿病患者的粮食不安全和血糖控制

目标

调查已诊断和未诊断糖尿病的成人食品不安全与血糖控制之间的关系。

方法

利用 2003 年至 2016 年期间的国家健康和营养调查 (NHANES)，使用家庭粮食不安全量表来衡量粮食不安全。使用 NHANES 检查期间收集的糖化血红蛋白 (HbA1c) 来测量血糖控制。根据测量的 HbA1c 以及对医生或其他健康专业人士是否告知他们患有糖尿病或正在服用糖尿病药物的反应，将个体分为未诊断糖尿病或已诊断糖尿病。使用 SAS 9.4 版进行单变量和多变量模型时使用了抽样权重和调查程序。

结果

大约 13.7% 的人口样本（35,216 名成年人，即 207,271,917 名美国成年人）报告了粮食不安全。报告粮食不安全与确诊糖尿病的 HbA1c 升高 0.37 相关（95% CI 0.15−0.60），与未确诊糖尿病的 HbA1c 升高 0.45 相关（95% CI 0.05−0.85）。在未确诊的糖尿病人群中，报告食品不安全的人群 HbA1c 高于 7% 的可能性高出 80%（OR = 1.80，95% CI 1.06–3.06）。

结论

对于未确诊的糖尿病患者来说，食品不安全与 HbA1c 的关系更为密切。结果表明，对可能患有未确诊糖尿病的高风险食品不安全个体进行筛查的重要性。