000 03828nam a22007097a 4500
008 200902s20202020 xxu||||| |||| 00| 0 eng d
022 _a1936-900X
024 _a10.5811/westjem.2020.4.45918 [doi]
024 _aPMC7390541 [pmc]
024 _awestjem.2020.4.45918 [pii]
040 _aOvid MEDLINE(R)
099 _a32726270
100 _aGoyal, Munish
100 _aMagee, Michelle
190 _aCacciapuoti M
190 _aDay H
190 _aGoyal M
190 _aHashemzadeh T
190 _aJarris YS
190 _aMagee M
190 _aNhoung HK
245 _aFood Insecurity and Insulin Use in Hyperglycemic Patients Presenting to the Emergency Department.
251 _aThe Western Journal of Emergency Medicine. 21(4):959-963, 2020 Jul 03.
251 _zThe Western Journal of Emergency Medicine. 21(4):959-963, 2020 Jul 03.
252 _aWest J Emerg Med. 21(4):959-963, 2020 Jul 03.
252 _zWest J Emerg Med. 21(4):959-963, 2020 Jul 03.
253 _aThe western journal of emergency medicine
260 _c2020
260 _sepublish
260 _sepublish
260 _z2020
269 _fFY2021
520 _aCONCLUSION: 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.
520 _aINTRODUCTION: 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.
520 _aMETHODS: 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.
520 _aRESULTS: 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).
546 _aEnglish
650 _a*Emergency Service, Hospital
650 _a*Hyperglycemia/dt [Drug Therapy]
650 _a*Insulins/tu [Therapeutic Use]
650 _a*Patient Compliance
650 _aAdult
650 _aAged
650 _aBlood Glucose/an [Analysis]
650 _aCross-Sectional Studies
650 _aDiabetes Mellitus
650 _aFemale
650 _aGlycated Hemoglobin A/an [Analysis]
650 _aHospitalization
650 _aHumans
650 _aMale
650 _aMiddle Aged
650 _aPrevalence
651 _aMedStar Washington Hospital Center
656 _aEmergency Medicine
656 _aMedicine/Endocrinology
657 _aJournal Article
856 _uhttps://dx.doi.org/10.5811/westjem.2020.4.45918
857 _uhttps://dx.doi.org/10.5811/westjem.2020.4.45918
857 _uhttps://dx.doi.org/10.5811/westjem.2020.4.45918
942 _cART
999 _c8976
_d8976