Food Insecurity and Insulin Use in Hyperglycemic Patients Presenting to the Emergency Department.
Food Insecurity and Insulin Use in Hyperglycemic Patients Presenting to the Emergency Department.
- 2020
CONCLUSION: Our exploratory findings suggest almost half of clinically stable adults presenting to our inner-city ED with hyperglycemia experience food insecurity. More than one-third of those prescribed insulin used less than their prescribed amount in the prior year. INTRODUCTION: The prevalence of food insecurity (FI) and insulin rationing among patients with diabetes who present to the emergency department (ED) is unclear. We examined the prevalence of food insecurity and subtherapeutic insulin use among patients who presented to the ED with a blood glucose level of greater than 250 milligrams per deciliter. METHODS: This was a single-center, cross-sectional survey of clinically stable, hyperglycemic adults in the ED for food insecurity using the Hunger Vital Sign screening tool. Patients who were insulin dependent were asked about insulin usage and rationing. RESULTS: Of the 85 eligible patients, 76 (89.4%) were enrolled; 35 (46%) screened positive for food insecurity. Food insecure patients were 1.9 times more likely to be hospitalized than non-food insecure patients (relative risk = 1.90 [1.21-2.99], p<.01). Food insecure patients were younger than non-food insecure patients (50.4 vs 57.5 p<.02), and had significantly higher hemoglobin A1c (HgbA1c) levels (11.2% vs 9.9% p = 0.04). Of the 49 patients prescribed insulin, 17 (34.6%) stated they had used less insulin during the prior week than had been prescribed, and 21 (42.9%) stated they had used less insulin during the prior year than had been prescribed. Food insecure patients were more likely to have used less insulin than prescribed in the prior year (odds ratio = 3.60 [1.09-11.9], p = 0.04).
English
1936-900X
10.5811/westjem.2020.4.45918 [doi] PMC7390541 [pmc] westjem.2020.4.45918 [pii]
*Emergency Service, Hospital
*Hyperglycemia/dt [Drug Therapy]
*Insulins/tu [Therapeutic Use]
*Patient Compliance
Adult
Aged
Blood Glucose/an [Analysis]
Cross-Sectional Studies
Diabetes Mellitus
Female
Glycated Hemoglobin A/an [Analysis]
Hospitalization
Humans
Male
Middle Aged
Prevalence
MedStar Washington Hospital Center
Emergency Medicine
Medicine/Endocrinology
Journal Article
CONCLUSION: Our exploratory findings suggest almost half of clinically stable adults presenting to our inner-city ED with hyperglycemia experience food insecurity. More than one-third of those prescribed insulin used less than their prescribed amount in the prior year. INTRODUCTION: The prevalence of food insecurity (FI) and insulin rationing among patients with diabetes who present to the emergency department (ED) is unclear. We examined the prevalence of food insecurity and subtherapeutic insulin use among patients who presented to the ED with a blood glucose level of greater than 250 milligrams per deciliter. METHODS: This was a single-center, cross-sectional survey of clinically stable, hyperglycemic adults in the ED for food insecurity using the Hunger Vital Sign screening tool. Patients who were insulin dependent were asked about insulin usage and rationing. RESULTS: Of the 85 eligible patients, 76 (89.4%) were enrolled; 35 (46%) screened positive for food insecurity. Food insecure patients were 1.9 times more likely to be hospitalized than non-food insecure patients (relative risk = 1.90 [1.21-2.99], p<.01). Food insecure patients were younger than non-food insecure patients (50.4 vs 57.5 p<.02), and had significantly higher hemoglobin A1c (HgbA1c) levels (11.2% vs 9.9% p = 0.04). Of the 49 patients prescribed insulin, 17 (34.6%) stated they had used less insulin during the prior week than had been prescribed, and 21 (42.9%) stated they had used less insulin during the prior year than had been prescribed. Food insecure patients were more likely to have used less insulin than prescribed in the prior year (odds ratio = 3.60 [1.09-11.9], p = 0.04).
English
1936-900X
10.5811/westjem.2020.4.45918 [doi] PMC7390541 [pmc] westjem.2020.4.45918 [pii]
*Emergency Service, Hospital
*Hyperglycemia/dt [Drug Therapy]
*Insulins/tu [Therapeutic Use]
*Patient Compliance
Adult
Aged
Blood Glucose/an [Analysis]
Cross-Sectional Studies
Diabetes Mellitus
Female
Glycated Hemoglobin A/an [Analysis]
Hospitalization
Humans
Male
Middle Aged
Prevalence
MedStar Washington Hospital Center
Emergency Medicine
Medicine/Endocrinology
Journal Article