Division of Behavioral Sciences and Community Health, School of Dental Medicine, UConn Health, 263 Farmington Avenue, Farmington, CT 06030-3910, USA.
Department of Public Health Sciences, School of Medicine, UConn Health, 263 Farmington Avenue, Farmington, CT 06030-6325, USA.
Nutrients. 2024 Jul 25;16(15):2406. doi: 10.3390/nu16152406.
The majority of data on food insecurity in diabetes comes from samples of type 2 diabetes or youth with type 1 diabetes. This study screened for food insecurity among adults with type 1 diabetes in the 2022 Behavioral Risk Factor Surveillance Survey, which was the first year that respondents who endorsed diabetes were asked to indicate whether they had type 1 or type 2. One validated screening item asked, "During the past 12 months, how often did the food that you bought not last and you didn't have money to buy more?". Respondents who answered "always", "usually", "sometimes", or "rarely" were categorized as having a positive screen for food insecurity. Seventy-six percent of the sample was white/non-Hispanic. Over one-quarter screened positive for food insecurity. This prevalence is higher than some reports of food insecurity in type 1 diabetes but consistent with reports that include 'marginal' food security in the count of food-insecure individuals. White/non-Hispanics had a lower risk of a positive screen than minoritized respondents. Respondents reporting older age, lower educational attainment, not working, lower income, and receiving SNAP benefits had higher rates of a positive screen. Significant healthcare factors associated with a positive screen were receiving government insurance instead of private, not being able to afford to see a doctor, and worse general, physical, and mental health. In conclusion, rates of a positive screen for food insecurity among people with type 1 diabetes in this study were alarmingly high and associated with other socioeconomic indicators. Screening for food insecurity with appropriate instruments for samples with type 1 diabetes, across the U.S. and internationally, should be a priority.
大多数关于糖尿病患者食物不安全的数据来自 2 型糖尿病或 1 型糖尿病青年患者的样本。本研究在 2022 年行为风险因素监测调查中筛查了 1 型糖尿病成年人的食物不安全情况，这是首次要求回答有糖尿病的受访者表明他们患有 1 型还是 2 型糖尿病的一年。一个经过验证的筛查项目询问：“在过去的 12 个月中，您购买的食物有多少次没有持续到下一次购买，而且您没有钱购买更多食物？”回答“总是”、“通常”、“有时”或“很少”的受访者被归类为对食物不安全有阳性筛查结果。样本中有 76%是白人和非西班牙裔。超过四分之一的人筛查出食物不安全。这一流行率高于一些 1 型糖尿病中食物不安全的报告，但与包括“边缘”食品安全在内的食物不安全人数的报告一致。白人和非西班牙裔的阳性筛查风险低于少数族裔受访者。报告年龄较大、教育程度较低、未工作、收入较低和接受 SNAP 福利的受访者阳性筛查率较高。与阳性筛查相关的重要医疗保健因素是接受政府保险而不是私人保险、负担不起看医生的费用以及更差的总体、身体和心理健康。总之，本研究中 1 型糖尿病患者阳性筛查食物不安全的比例高得惊人，并且与其他社会经济指标有关。在美国和国际上，使用适当的工具对 1 型糖尿病患者进行食物不安全筛查应成为优先事项。
