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The longitudinal relationship between food insecurity in older adults with diabetes and emergency department visits, hospitalizations, hemoglobin A1c, and medication adherence

E.B. Schroeder, C. Zenga, A.T. Sterrett, T.K. Kimpo, A.R. Paolino, J.F. Steiner
J Diabetes Complications

Aims: To examine the relationship between food insecurity and emergency department (ED) visits, hospitalizations, A1c, and diabetes medication adherence over one year of follow-up among individuals >65years with diabetes mellitus.

Methods: We conducted a longitudinal cohort study of adults >65years with diabetes who did (n=742) or did not (n=2226) report food insecurity at baseline. We used conditional logistic regression for the ED visits or hospitalization outcomes, and mixed effects models for A1c and non-insulin diabetes medication adherence.

Results: In bivariate analyses, individuals with food insecurity were more likely to have an ED visit (OR=1.40, 95% CI 1.15-1.72) or hospitalization (OR=1.41, 95% CI 1.11-1.78) in the year after the food security assessment. In addition, A1c was higher (7.5% vs. 7.2%, p

Conclusions: Differences in diabetes outcomes by food insecurity status were attenuated by adjustment for socioeconomic status. Adverse outcomes in individuals with diabetes and food insecurity may be driven by effects of food insecurity per se or be mediated by a constellation of basic resource needs or lower socioeconomic status.

Schroeder EB, Zeng C, Sterrett AT, Kimpo TK, Paolino AR, Steiner JF. The longitudinal relationship between food insecurity in older adults with diabetes and emergency department visits, hospitalizations, hemoglobin A1c, and medication adherence. J Diabetes Complications. 2018. Epub ahead of print. PMID: 30717893. DOI: 10.1016/j.jdiacomp.2018.11.011.

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Publication year
Resource type
Peer Reviewed Research
Outcomes
Social Needs/ SDH
Utilization
Social Determinant of Health
Food/Hunger
Study design
Pre-post without Comparison Group