Association Between Food Insecurity and Inability to Obtain Provider-Recommended Medications, Multidisciplinary Services, and Technology in Youth and Young Adults With Diabetes: A Cross-Sectional Study

IF 3.7 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Endocrine Practice Pub Date : 2025-03-01 DOI:10.1016/j.eprac.2024.11.014

Nadine El Kalach MS , Emmanuel F. Julceus MD , A. Caroline Rudisill PhD , Faisal S. Malik MD , Kate Flory PhD , Edward A. Frongillo PhD , Katherine A. Sauder PhD , Jason A. Mendoza MD , Angela D. Liese PhD

{"title":"Association Between Food Insecurity and Inability to Obtain Provider-Recommended Medications, Multidisciplinary Services, and Technology in Youth and Young Adults With Diabetes: A Cross-Sectional Study","authors":"Nadine El Kalach MS , Emmanuel F. Julceus MD , A. Caroline Rudisill PhD , Faisal S. Malik MD , Kate Flory PhD , Edward A. Frongillo PhD , Katherine A. Sauder PhD , Jason A. Mendoza MD , Angela D. Liese PhD","doi":"10.1016/j.eprac.2024.11.014","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>We assessed if food insecurity (FI) is associated with not obtaining recommended diabetes medications, technology, and multidisciplinary services, and explored the most common reasons for not obtaining recommended treatments in youth and young adults (YYA) with diabetes.</div></div><div><h3>Methods</h3><div>In this cross-sectional study, among 911 YYA with type 1 diabetes (T1D) and 144 with type 2 diabetes (T2D) from the SEARCH Food Security Cohort Study Follow-up 1 (2018-2021), FI (≥ 3 items affirmed from the 18-item Household Food Security Survey module), and inability to obtain recommended treatments were self-reported.</div></div><div><h3>Results</h3><div>Almost 30% of YYA with T1D and FI and 20% of YYA with T2D and FI did not obtain 1 or more recommended treatments. Participants with T1D who reported FI had higher odds of not obtaining insulin (OR 3.2, 95% CI 1.2-8.4), mental health counseling (OR 3.3, 95% CI 1.3-8.2), diabetes education (OR 3.6, 95% CI 1.4-9.3), an insulin pump (OR 2.2, 95% CI 1.2-4.4), and a continuous glucose monitor (OR 2.5, 95% CI 1.5-4.4) compared to those who reported food security. Among participants with T2D, FI was related to not obtaining dietician services (OR 8.1, 95% CI 1.2-53.8). Participants with T1D and FI reported more financial reasons for not obtaining a continuous glucose monitor compared to food secure participants.</div></div><div><h3>Conclusion</h3><div>YYA with diabetes and FI face constraints in obtaining medications, diabetes technology, and multidisciplinary services, largely due to financial and structural reasons. New strategies are needed to bridge the gap between medical care required vs obtained by YYA with diabetes.</div></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":"31 3","pages":"Pages 298-305"},"PeriodicalIF":3.7000,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Endocrine Practice","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1530891X24008450","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}

引用次数: 0

Abstract

Objective

We assessed if food insecurity (FI) is associated with not obtaining recommended diabetes medications, technology, and multidisciplinary services, and explored the most common reasons for not obtaining recommended treatments in youth and young adults (YYA) with diabetes.

Methods

In this cross-sectional study, among 911 YYA with type 1 diabetes (T1D) and 144 with type 2 diabetes (T2D) from the SEARCH Food Security Cohort Study Follow-up 1 (2018-2021), FI (≥ 3 items affirmed from the 18-item Household Food Security Survey module), and inability to obtain recommended treatments were self-reported.

Results

Almost 30% of YYA with T1D and FI and 20% of YYA with T2D and FI did not obtain 1 or more recommended treatments. Participants with T1D who reported FI had higher odds of not obtaining insulin (OR 3.2, 95% CI 1.2-8.4), mental health counseling (OR 3.3, 95% CI 1.3-8.2), diabetes education (OR 3.6, 95% CI 1.4-9.3), an insulin pump (OR 2.2, 95% CI 1.2-4.4), and a continuous glucose monitor (OR 2.5, 95% CI 1.5-4.4) compared to those who reported food security. Among participants with T2D, FI was related to not obtaining dietician services (OR 8.1, 95% CI 1.2-53.8). Participants with T1D and FI reported more financial reasons for not obtaining a continuous glucose monitor compared to food secure participants.

Conclusion

YYA with diabetes and FI face constraints in obtaining medications, diabetes technology, and multidisciplinary services, largely due to financial and structural reasons. New strategies are needed to bridge the gap between medical care required vs obtained by YYA with diabetes.

查看原文本刊更多论文

青少年糖尿病患者食品不安全与无法获得医生推荐的药物、多学科服务和技术之间的关系：一项横断面研究。

目的：我们评估了食物不安全（FI）是否与无法获得推荐的糖尿病药物、技术和多学科服务有关，并探讨了青少年和年轻成人（YYA）糖尿病患者无法获得推荐治疗的最常见原因。方法：在这项横断面研究中，来自SEARCH食品安全队列研究随访1（2018-2021）的911名1型糖尿病（T1D）和144名2型糖尿病（T2D）的YYA患者中，FI（从18项家庭食品安全调查模块中确认≥3项）和无法获得推荐治疗的自我报告。结果：近30%合并T1D和FI的YYA和20%合并T2D和FI的YYA没有接受一种或多种推荐治疗。报告FI的T1D患者与报告食品安全（FS）的患者相比，未获得胰岛素（OR 3.2, 95% CI 1.2-8.4）、心理健康咨询（OR 3.3, 95% CI 1.3-8.2）、糖尿病教育（OR 3.6, 95% CI 1.4-9.3）、胰岛素泵（OR 2.2, 95% CI 1.2- 4.4）和连续血糖监测（OR 2.5, 95% CI 1.5-4.4）的几率更高。在患有T2D的参与者中，FI与未获得营养师服务有关（OR 8.1, 95% CI 1.2-53.8）。与FS参与者相比，患有T1D和FI的参与者报告了更多没有获得CGM的经济原因。结论：YYA合并糖尿病和FI在获得药物、糖尿病技术和多学科服务方面面临限制，主要是由于经济和结构原因。需要新的策略来弥合YYA糖尿病患者所需的医疗保健与获得的医疗保健之间的差距。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Endocrine Practice ENDOCRINOLOGY & METABOLISM-

CiteScore

7.60

自引率

2.40%

发文量

546

审稿时长

41 days

期刊介绍： Endocrine Practice (ISSN: 1530-891X), a peer-reviewed journal published twelve times a year, is the official journal of the American Association of Clinical Endocrinologists (AACE). The primary mission of Endocrine Practice is to enhance the health care of patients with endocrine diseases through continuing education of practicing endocrinologists.