Knight Chadwick K, Probst Janice C, Liese Angela D, Sercye Erica, Jones Sonya J
South Carolina Department of Health and Environmental Control, United States.
Department of Health Services Policy and Management, Arnold School of Public Health, 915 Greene Street, Room 355, University of South Carolina, Columbia, SC 29208, United States.
Prev Med. 2016 Feb;83:41-5. doi: 10.1016/j.ypmed.2015.11.031. Epub 2015 Dec 4.
Our research examined the prevalence of food insecurity among adults with self-reported diabetes and whether food insecurity was associated with cutting back ("scrimping") on prescribed medications because of financial constraints.
We conducted a cross-sectional analysis of data from the 2011 National Health Interview Survey (NHIS). Adults completing this survey were considered to have diabetes if they reported current use of insulin or "diabetic pills" (n=3,242). Food insecurity was determined with a 10-item scale; respondents were categorized as food secure (FS), marginally food secure (MFS) or food insecure (FI).
Approximately one in six adults in NHIS with diabetes reported food insecurity (17.0%), and an additional 8.8% were marginally FS. An individual was considered to be scrimping on medications if he/she gave a "yes" response to at least one of four questions pertaining to reduced, delayed or avoided medication use. Overall, 18.9% of respondents with diabetes reported one or more type of medication scrimping: 11.7% of FS individuals, 27.7% of MFS individuals and 45.6% of FI individuals. In adjusted analyses, marginal food security and food insecurity remained strongly associated with scrimping.
One-quarter of adults with diabetes may have difficulty obtaining foods appropriate for a diabetic diet; a substantial number of these individuals also fail to obtain or take medications. Practitioners may miss either problem unless targeted questions are included in clinical encounters. Clinicians should consider referring FI and MFS diabetic patients to community food resources.
我们的研究调查了自我报告患有糖尿病的成年人中粮食不安全的患病率，以及粮食不安全是否与因经济限制而减少（“节省”）处方药的服用有关。
我们对2011年国家健康访谈调查（NHIS）的数据进行了横断面分析。完成该调查的成年人如果报告目前正在使用胰岛素或“糖尿病药物”，则被视为患有糖尿病（n = 3,242）。粮食不安全通过一个包含10个项目的量表来确定；受访者被分类为粮食安全（FS）、边缘粮食安全（MFS）或粮食不安全（FI）。
在NHIS中，约六分之一患有糖尿病的成年人报告粮食不安全（17.0%），另有8.8%为边缘粮食安全。如果一个人对与减少、延迟或避免用药相关的四个问题中的至少一个回答“是”，则被认为是在节省用药。总体而言，18.9%的糖尿病受访者报告有一种或多种类型的用药节省情况：FS个体中有11.7%，MFS个体中有27.7%，FI个体中有45.6%。在调整分析中，边缘粮食安全和粮食不安全仍然与节省用药密切相关。
四分之一患有糖尿病的成年人可能难以获得适合糖尿病饮食的食物; 这些人中相当一部分也无法获得或服用药物。除非在临床问诊中纳入针对性问题，从业者可能会忽略这两个问题。临床医生应考虑将FI和MFS糖尿病患者转介至社区粮食资源处。
