估算满足食物需求对糖尿病治疗效果的影响

IF 3.6 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Ssm-Population Health Pub Date : 2024-09-01 DOI:10.1016/j.ssmph.2024.101709

Seth A. Berkowitz , Aileen Ochoa , Jenna M. Donovan , Jenine Dankovchik , Myklynn LaPoint , Marlena L. Kuhn , Suzanne Morrissey , Mufeng Gao , Michael G. Hudgens , Sanjay Basu , Rachel Gold

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引用次数: 0

摘要

研究设计与方法纵向队列研究，采用目标试验模拟法。96,792 名 2 型糖尿病成人在社区医疗中心网络中接受了食物需求评估，并在初次评估后接受了长达 36 个月的随访。我们采用目标最小损失估计法估算了未经历食物需求与经历食物需求之间的关系，以及血红蛋白 a1c (HbA1c)、收缩压和舒张压 (SBP 和 DBP) 和低密度脂蛋白胆固醇之间的关系。研究时间为 2016 年 6 月 24 日至 2023 年 4 月 30 日。结果我们估计，与有食物需求的人相比，没有食物需求的人在 12 个月时的平均 HbA1c 会降低 0.12 个百分点（95% 置信区间 [CI] -0.16% 至 -0.09%，p = < 0.0001）。我们进一步估计，不需要食物会使 12 个月的 SBP 降低 0.67 mm Hg（95%CI -0.97 至 -0.38 mm Hg，p = 0.0001），DBP 降低 0.21 mm Hg（95%CI -0.38 至 -0.04 mm Hg，p = 0.01）。与低密度脂蛋白胆固醇的降低没有关联。其他时间点的结果类似，HbA1c、SBP 和 DBP 的关联程度相似，低密度脂蛋白胆固醇没有差异。这些研究结果支持测试将满足食物需求作为其作用机制一部分的干预措施。

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Estimating the impact of addressing food needs on diabetes outcomes

Objective

To estimate the association between food needs and diabetes outcomes.

Research design and methods

Longitudinal cohort study, using a target trial emulation approach. 96,792 adults with type 2 diabetes mellitus who underwent food need assessment in a network of community-based health centers were followed up to 36 months after initial assessment. We used targeted minimum loss estimation to estimate the association between not experiencing food needs, compared with experiencing food needs, and hemoglobin a1c (HbA1c), systolic and diastolic blood pressure (SBP and DBP), and LDL cholesterol. The study period was June 24th, 2016 to April 30th, 2023.

Results

We estimated that not experiencing food needs, compared with experiencing food needs, would be associated with 0.12 percentage points lower (95% Confidence Interval [CI] −0.16% to −0.09%, p = < 0.0001) mean HbA1c at 12 months. We further estimated that not experiencing food needs would be associated with a 12-month SBP that was 0.67 mm Hg lower (95%CI -0.97 to −0.38 mm Hg, p < .0001), DBP 0.21 mm Hg lower (95%CI -0.38 to −0.04 mm Hg, p = .01). There was no association with lower LDL cholesterol. Results were similar at other timepoints, with associations for HbA1c, SBP, and DBP of similar magnitude, and no difference in LDL cholesterol.

Conclusions

We estimated that not experiencing food needs may be associated with modestly better diabetes outcomes. These findings support testing interventions that address food needs as part of their mechanism of action.

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来源期刊

Ssm-Population Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

6.50

自引率

2.10%

发文量

298

审稿时长

101 days

期刊介绍： SSM - Population Health. The new online only, open access, peer reviewed journal in all areas relating Social Science research to population health. SSM - Population Health shares the same Editors-in Chief and general approach to manuscripts as its sister journal, Social Science & Medicine. The journal takes a broad approach to the field especially welcoming interdisciplinary papers from across the Social Sciences and allied areas. SSM - Population Health offers an alternative outlet for work which might not be considered, or is classed as ''out of scope'' elsewhere, and prioritizes fast peer review and publication to the benefit of authors and readers. The journal welcomes all types of paper from traditional primary research articles, replication studies, short communications, methodological studies, instrument validation, opinion pieces, literature reviews, etc. SSM - Population Health also offers the opportunity to publish special issues or sections to reflect current interest and research in topical or developing areas. The journal fully supports authors wanting to present their research in an innovative fashion though the use of multimedia formats.