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Household Food Insecurity and Fear of Hypoglycemia in Adolescents and Young Adults with Diabetes and Parents of Youth with Diabetes

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posted on 2022-06-30, 17:15 authored by Lauren A. Reid, Siyu Zheng, Jason A. Mendoza, Beth A. Reboussin, Alissa Roberts, Katherine A. Sauder, Jean M. Lawrence, Elizabeth Jensen, Leora Henkin, Kate Flory, Lisa Knight, Catherine Pihoker, Lawrence M. Dolan, Elaine Apperson, Angela D. Liese

  

Objective: To evaluate the relation between household food insecurity (HFI) and fear of hypoglycemia among young adults with type 1 and type 2 diabetes, adolescents with type 1 diabetes, and their parents. 

Research Design and Methods: We analyzed cross-sectional data of 1,676 young adults with youth-onset diabetes (84% type 1, 16% type 2) and 568 adolescents (<18 years; mean age 15.1 years) with type 1 from the SEARCH for Diabetes in Youth Study. Adult participants and parents of adolescent participants completed the US Household Food Security Survey. Adults, adolescents, and parents of adolescents completed the Hypoglycemia Fear Survey, where answers range from 1-4. The outcomes were the mean score for fear of hypoglycemia and the behavior and worry subscale scores. Linear regression models identified associations between HFI and fear of hypoglycemia scores.

Results: Adults with type 1 diabetes experiencing HFI had higher fear of hypoglycemia scores (+0.22 units for behavior, +0.55 units for worry, +0.40 units for total, all p<0.0001) than those without HFI. No differences by HFI status were found for adolescents with type 1 diabetes. Parents of adolescents reporting HFI had a 0.18 unit higher worry score than those not reporting HFI (p<0.05). Adults with type 2 diabetes experiencing HFI had higher fear of hypoglycemia scores (+0.19 units for behavior, +0.35 units for worry, +0.28 units for total; all p<0.05) than those in food secure households.

Conclusions: Screening for HFI and fear of hypoglycemia among people with diabetes can help providers tailor diabetes education for those who have HFI and therefore fear hypoglycemia.

Funding

The SEARCH for Diabetes in Youth Cohort Study (1R01DK127208-01, 1UC4DK108173) is funded by the National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases and supported by the Centers for Disease Control and Prevention. The Population Based Registry of Diabetes in Youth Study (1U18DP006131, U18DP006133, U18DP006134, U18DP006136, U18DP006138, and U18DP006139) is funded by the Centers for Disease Control and Prevention (DP-15-002) and supported by the National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases. Grant Support (SEARCH 1, 2, 3): SEARCH for Diabetes in Youth is funded by the Centers for Disease Control and Prevention (PA numbers 00097, DP-05-069, and DP-10-001) and supported by the National Institute of Diabetes and Digestive and Kidney Diseases. Kaiser Permanente Southern California (U48/CCU919219, U01 DP000246, and U18DP002714), University of Colorado Denver (U48/CCU819241-3, U01 DP000247, and U18DP000247-06A1), Cincinnati's Children's Hospital Medical Center (U48/CCU519239, U01 DP000248, and 1U18DP002709), University of North Carolina at Chapel Hill (U48/CCU419249, U01 DP000254, and U18DP002708), Seattle Children's Hospital (U58/CCU019235-4, U01 DP000244, and U18DP002710-01] and Wake Forest University School of Medicine (U48/CCU919219, U01 DP000250, and 200-2010-35171). This work is also funded by the SEARCH Food Security Cohort Study (5R01DK117461-03). The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention and the National Institute of Diabetes and Digestive and Kidney Diseases.

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