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Food Insecurity Is Associated With Poorer Glycemic Control in Patients Receiving Free Versus Fee-Based Care.

David H Holben1, Kara A Brown2, Jay H Shubrook3

  • 1The University of Mississippi School of Applied Sciences, University, MS.

Clinical Diabetes : a Publication of the American Diabetes Association
|February 2, 2019
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Summary
This summary is machine-generated.

Patients using free clinics for diabetes care reported lower household food security (HFS) and household adult food security (HAFS), alongside poorer A1C levels, compared to those using fee-for-service clinics.

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Area of Science:

  • Public Health
  • Diabetes Management
  • Health Services Research

Background:

  • Food security is a critical determinant of health outcomes, particularly for chronic conditions like diabetes.
  • Access to healthcare services, whether free or fee-for-service, can influence patient well-being and disease management.
  • Understanding disparities in food security and diabetes care is essential for equitable healthcare delivery.

Purpose of the Study:

  • To compare household food security (HFS), household adult food security (HAFS), and diabetes management indicators between patients attending free clinics versus fee-for-service clinics.
  • To investigate the relationship between food security status and glycemic control (A1C) in individuals with diabetes.
  • To identify potential disparities in diabetes care related to clinic type and socioeconomic factors.

Main Methods:

  • Cross-sectional study comparing 166 adult participants with diabetes receiving care at free clinics (n=41) and fee-for-service clinics (n=125).
  • Data collected on demographic characteristics, household food security (HFS), household adult food security (HAFS), and A1C levels.
  • Statistical analyses used to determine differences between clinic groups and correlations between food security and A1C.

Main Results:

  • Significant differences were found in both HFS (P <0.001) and HAFS (P <0.001) between the free and fee-for-service clinic groups.
  • Patients in free clinics had a higher mean A1C (8.7 ± 1.7%) compared to those in fee-for-service clinics (7.8 ± 1.6%; P = 0.005).
  • A1C levels increased significantly as both HFS (r = 0.293, P <0.001) and HAFS (r = 0.288, P = 0.001) worsened.

Conclusions:

  • Patients utilizing free clinics for diabetes care experience greater food insecurity and poorer glycemic control compared to those in fee-for-service settings.
  • Food insecurity is directly associated with worse diabetes management outcomes, highlighting a critical barrier to care.
  • Healthcare systems should address food security as a fundamental component of diabetes management, particularly for vulnerable populations accessing free clinics.