A new study has found a link between poor diabetes control and a patient’s difficulty in paying for food and medication.
For their study, researchers led by Seth A. Berkowitz, M.D., M.P.H., of Massachusetts General Hospital in Boston set out to determine the association between economic insecurities and diabetes control and the use of health care resources.
The study included data from 411 patients collected from June 2012 through October 2013 at a primary care clinic, two community health centers, and a specialty treatment center for diabetes in Massachusetts.
The researchers found that 19.1 percent of patients reported food insecurity; 27.6 percent cited cost-related medication underuse; 10.7 percent had housing instability; 14.1 percent had trouble paying for utilities; and 39.1 percent reported at least one material need insecurity.
Poor diabetes control — as measured by factors including hemoglobin A1c, low-density lipoprotein cholesterol level, or blood pressure — was seen in 46 percent of patients, according to the study’s findings.
The study determined that food insecurity was associated with greater odds of poor diabetes control and increased outpatient visits, but not increased emergency department (ED) or inpatient visits.
Cost-related medication underuse was associated with poor diabetes control and increased ED and inpatient visits, but not outpatient visits.
Housing instability and insecurity about utilities were associated with increased outpatient visits but not with diabetes control or with ED or outpatient visits.
Lastly, the study showed that having an increasing number of economic insecurities was associated with poor diabetes control and increased health care use.
“Health care systems are increasingly accountable for health outcomes that have roots outside of clinical care,” the researchers said in the study, which was published in JAMA Internal Medicine.
“Because of this development, strategies that increase access to health care resources might reasonably be coupled with those that address social determinants of health, including material need insecurities. In particular, food insecurity and cost-related medication underuse may be promising targets for real-world management of diabetes mellitus.”
Source: JAMA Network