Thanh Tran, Angelica Cristello Sarteau, Cy Fogleman, Laura Anne Young, Elizabeth Mayer-Davis
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During the pandemic, food insecurity prevalence and HbA1c were significantly (p < .05) higher among non-Whites (39%, 8.4% ± 2.1) compared to Whites (15%, 7.8% ±1.6). HbA1c among those who were very food insecure was 1.00% (95% CI: 0.222, 1.762, p = .01) higher than those who were food secure. Those with increased food insecurity had a 0.58% (95% CI: 0.024, 1.128, p = .04) higher HbA1c increase than among those experiencing no change. No effect modification was detected. Limitations Convenience sampling in an endocrinology clinic, recall bias, and inadequate power may underlie null effect modification results. Conclusion Although effect modification was not detected, racial disparities in HbA1c and food insecurity warrant further investigation. These disparities, combined with the significant impact of food insecurity on HbA1c, suggest that prioritization of resources to high-risk populations should be considered early during public emergencies to minimize short- and long-term health consequences.","PeriodicalId":39574,"journal":{"name":"North Carolina Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2023-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Disparities in Food Security and Glycemic Control Among People with Type 2 Diabetes During the COVID-19 Pandemic\",\"authors\":\"Thanh Tran, Angelica Cristello Sarteau, Cy Fogleman, Laura Anne Young, Elizabeth Mayer-Davis\",\"doi\":\"10.18043/001c.88084\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Background Little is known about the differing impacts of food insecurity on HbA1c by race in type 2 diabetes (T2D). Predictions around increased food insecurity from COVID-19 exacerbating racial disparities led us to estimate its prevalence and associations with HbA1c by race during the COVID-19 pandemic. Methods Data came from medical records and surveys among a clinic-based sample of T2D patients. Linear regression models estimated associations between food insecurity and HbA1c and between change in food insecurity and change in HbA1c. Likelihood ratio tests and examination of stratum-specific estimates assessed effect modification by race. Results Our sample was 59% White, 59% female, and mean age was 60.8 ± 12.6. During the pandemic, food insecurity prevalence and HbA1c were significantly (p < .05) higher among non-Whites (39%, 8.4% ± 2.1) compared to Whites (15%, 7.8% ±1.6). HbA1c among those who were very food insecure was 1.00% (95% CI: 0.222, 1.762, p = .01) higher than those who were food secure. Those with increased food insecurity had a 0.58% (95% CI: 0.024, 1.128, p = .04) higher HbA1c increase than among those experiencing no change. No effect modification was detected. Limitations Convenience sampling in an endocrinology clinic, recall bias, and inadequate power may underlie null effect modification results. Conclusion Although effect modification was not detected, racial disparities in HbA1c and food insecurity warrant further investigation. These disparities, combined with the significant impact of food insecurity on HbA1c, suggest that prioritization of resources to high-risk populations should be considered early during public emergencies to minimize short- and long-term health consequences.\",\"PeriodicalId\":39574,\"journal\":{\"name\":\"North Carolina Medical Journal\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2023-09-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"North Carolina Medical Journal\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.18043/001c.88084\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"North Carolina Medical Journal","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.18043/001c.88084","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
摘要
对于不同种族的2型糖尿病(T2D)患者,食物不安全对HbA1c的不同影响知之甚少。关于COVID-19加剧粮食不安全的预测加剧了种族差异,这使我们在COVID-19大流行期间按种族估计其患病率及其与HbA1c的关联。方法数据来源于临床T2D患者的医疗记录和调查。线性回归模型估计了粮食不安全与糖化血红蛋白之间的关系,以及粮食不安全变化与糖化血红蛋白变化之间的关系。似然比检验和层特异性估计的检验评估了不同种族的效果改变。结果本组患者白人59%,女性59%,平均年龄60.8±12.6岁。大流行期间,粮食不安全患病率和糖化血红蛋白显著(p <.05)非白人(39%,8.4%±2.1)高于白人(15%,7.8%±1.6)。食物非常不安全组的糖化血红蛋白比食物安全组高1.00% (95% CI: 0.222, 1.762, p = 0.01)。那些食物不安全状况增加的人的糖化血红蛋白比没有变化的人高0.58% (95% CI: 0.024, 1.128, p = 0.04)。未检测到任何效果修饰。在内分泌门诊方便取样、回忆偏倚和功率不足可能是无效修正结果的基础。结论虽然没有发现效应修饰,但在HbA1c和食品不安全方面的种族差异值得进一步调查。这些差异,再加上粮食不安全对糖化血红蛋白的重大影响,表明在突发公共事件期间应及早考虑将资源优先用于高危人群,以尽量减少短期和长期的健康后果。
Disparities in Food Security and Glycemic Control Among People with Type 2 Diabetes During the COVID-19 Pandemic
Background Little is known about the differing impacts of food insecurity on HbA1c by race in type 2 diabetes (T2D). Predictions around increased food insecurity from COVID-19 exacerbating racial disparities led us to estimate its prevalence and associations with HbA1c by race during the COVID-19 pandemic. Methods Data came from medical records and surveys among a clinic-based sample of T2D patients. Linear regression models estimated associations between food insecurity and HbA1c and between change in food insecurity and change in HbA1c. Likelihood ratio tests and examination of stratum-specific estimates assessed effect modification by race. Results Our sample was 59% White, 59% female, and mean age was 60.8 ± 12.6. During the pandemic, food insecurity prevalence and HbA1c were significantly (p < .05) higher among non-Whites (39%, 8.4% ± 2.1) compared to Whites (15%, 7.8% ±1.6). HbA1c among those who were very food insecure was 1.00% (95% CI: 0.222, 1.762, p = .01) higher than those who were food secure. Those with increased food insecurity had a 0.58% (95% CI: 0.024, 1.128, p = .04) higher HbA1c increase than among those experiencing no change. No effect modification was detected. Limitations Convenience sampling in an endocrinology clinic, recall bias, and inadequate power may underlie null effect modification results. Conclusion Although effect modification was not detected, racial disparities in HbA1c and food insecurity warrant further investigation. These disparities, combined with the significant impact of food insecurity on HbA1c, suggest that prioritization of resources to high-risk populations should be considered early during public emergencies to minimize short- and long-term health consequences.
期刊介绍:
NCMJ, the North Carolina Medical Journal, is meant to be read by everyone with an interest in improving the health of North Carolinians. We seek to make the Journal a sounding board for new ideas, new approaches, and new policies that will deliver high quality health care, support healthy choices, and maintain a healthy environment in our state.