Department of Pediatrics, University of Washington, Seattle, WA.
Seattle Children's Research Institute, Seattle, WA.
Diabetes Care. 2023 Feb 1;46(2):278-285. doi: 10.2337/dc21-0790.
To assess the prevalence of household food insecurity (HFI) and Supplemental Nutrition Assistance Program (SNAP) participation among youth and young adults (YYA) with diabetes overall and by type, and sociodemographic characteristics.
The study included participants with youth-onset type 1 diabetes and type 2 diabetes from the SEARCH for Diabetes in Youth study. HFI was assessed using the 18-item U.S. Household Food Security Survey Module (HFSSM) administered from 2016 to 2019; three or more affirmations on the HFSSM were considered indicative of HFI. Participants were asked about SNAP participation. We used χ2 tests to assess whether the prevalence of HFI and SNAP participation differed by diabetes type. Multivariable logistic regression models were used to examine differences in HFI by participant characteristics.
Of 2,561 respondents (age range, 10-35 years; 79.6% ≤25 years), 2,177 had type 1 diabetes (mean age, 21.0 years; 71.8% non-Hispanic White, 11.8% non-Hispanic Black, 13.3% Hispanic, and 3.1% other) and 384 had type 2 diabetes (mean age, 24.7 years; 18.8% non-Hispanic White, 45.8% non-Hispanic Black, 23.7% Hispanic, and 18.7% other). The overall prevalence of HFI was 19.7% (95% CI 18.1, 21.2). HFI was more prevalent in type 2 diabetes than type 1 diabetes (30.7% vs. 17.7%; P < 0.01). In multivariable regression models, YYA receiving Medicaid or Medicare or without insurance, whose parents had lower levels of education, and with lower household income had greater odds of experiencing HFI. SNAP participation was 14.1% (95% CI 12.7, 15.5), with greater participation among those with type 2 diabetes compared with those with type 1 diabetes (34.8% vs. 10.7%; P < 0.001).
Almost one in three YYA with type 2 diabetes and more than one in six with type 1 diabetes reported HFI in the past year-a significantly higher prevalence than in the general U.S. population.
评估总体和按糖尿病类型划分的青年和年轻成年人（YYA）中家庭食物不安全（HFI）和补充营养援助计划（SNAP）参与的流行率，并评估其社会人口学特征。
该研究纳入了来自青少年糖尿病研究（SEARCH for Diabetes in Youth study）的青年起病 1 型糖尿病和 2 型糖尿病患者。使用美国家庭食物安全调查模块（HFSSM）中的 18 项问题评估 HFI，该模块从 2016 年至 2019 年进行管理；HFSSM 上有三个或更多肯定回答被认为表明存在 HFI。询问参与者 SNAP 的参与情况。我们使用 χ2 检验评估 HFI 和 SNAP 参与率是否因糖尿病类型而异。使用多变量逻辑回归模型检查 HFI 参与者特征的差异。
在 2561 名应答者中（年龄范围 10-35 岁；79.6%≤25 岁），2177 名患有 1 型糖尿病（平均年龄 21.0 岁；71.8%非西班牙裔白人，11.8%非西班牙裔黑人，13.3%西班牙裔，3.1%其他），384 名患有 2 型糖尿病（平均年龄 24.7 岁；18.8%非西班牙裔白人，45.8%非西班牙裔黑人，23.7%西班牙裔，18.7%其他）。HFI 的总体流行率为 19.7%（95%CI 18.1，21.2）。2 型糖尿病的 HFI 患病率高于 1 型糖尿病（30.7%比 17.7%；P<0.01）。在多变量回归模型中，接受医疗补助或医疗保险或没有保险的 YYA，其父母教育程度较低，家庭收入较低，更有可能经历 HFI。SNAP 的参与率为 14.1%（95%CI 12.7，15.5），与 1 型糖尿病相比，2 型糖尿病的参与率更高（34.8%比 10.7%；P<0.001）。
过去一年中，近三分之一的 2 型糖尿病 YYA 和超过六分之一的 1 型糖尿病 YYA 报告了 HFI——这一流行率明显高于美国一般人群。
