Evidence map›Paper›PMID 38767746›Full record

ArticleJournal of general internal medicine2024

Food Insecurity and Hypoglycemia among Older Patients with Type 2 Diabetes Treated with Insulin or Sulfonylureas: The Diabetes & Aging Study.

Andrew J Karter, Melissa M Parker, Elbert S Huang, Hilary K Seligman, Howard H Moffet, James D Ralston, Jennifer Y Liu, Lisa K Gilliam, Neda Laiteerapong, Richard W Grant and 1 more

Abstract read
In one paragraph

Article in Journal of general internal medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Individualized treatment of diabetes mellitus in older adults.Geriatrics & gerontology international · 2024
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Andrew J KarterKaiser Permanente Northern California Division of Research, Pleasanton, CA, USA. andy.j.karter@kp.org.ORCID 0000-0001-5527-316X
Melissa M ParkerKaiser Permanente Northern California Division of Research, Pleasanton, CA, USA.
Elbert S HuangSection of General Internal Medicine, Department of Medicine, University of Chicago, Chicago, IL, USA.
Hilary K SeligmanDivision of General Internal Medicine at San Francisco General Hospital, University of California San Francisco Center for Vulnerable Populations, San Francisco, CA, USA.
Howard H MoffetKaiser Permanente Northern California Division of Research, Pleasanton, CA, USA.
James D RalstonKaiser Permanente Washington Health Research Institute, Seattle, WA, USA.
Jennifer Y LiuKaiser Permanente Northern California Division of Research, Pleasanton, CA, USA.
Lisa K GilliamKaiser Northern California Diabetes Program, Endocrinology and Internal Medicine, Kaiser Permanente, South San Francisco Medical Center, South San Francisco, CA, USA.
Neda LaiteerapongSection of General Internal Medicine, Department of Medicine, University of Chicago, Chicago, IL, USA.
Richard W GrantKaiser Permanente Northern California Division of Research, Pleasanton, CA, USA.
Kasia J LipskaSection of Endocrinology, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA.

Funding

Yale Clinical and Translational Science Award (U Component)UL1TR001863 · NCATS · YALE UNIVERSITY · PI John H. Krystal, LUCILA OHNO-MACHADO · 2016 to 2026
$102.9M
Research Design, Data, and Analytics CoreP30DK092949 · NIDDK · UNIVERSITY OF CHICAGO · PI ELBERT S. HUANG · 2011 to 2026
$10.0M
Translational Research Core - Health Engagement & Action Translational (HEAT)P30DK092924 · NIDDK · KAISER FOUNDATION RESEARCH INSTITUTE · PI Alyce Sophia Adams, HILARY Kessler SELIGMAN · 2011 to 2026
$9.2M
Optimizing Medical Decision Making for Older Patients with Type 2 DiabetesR01AG063391 · NIA · KAISER FOUNDATION RESEARCH INSTITUTE · PI HUANG, ELBERT S., KARTER, ANDREW JOHN · 2019 to 2023
$3.2M
Diabetes and Aging in a Multi-Ethnic PopulationR01DK081796 · NIDDK · KAISER FOUNDATION RESEARCH INSTITUTE · PI HUANG, ELBERT S., KARTER, ANDREW JOHN · 2009 to 2013
$2.9M
Preferences, Management, and Outcomes in the Oldest Patients with DiabetesR56AG051683 · NIA · KAISER FOUNDATION RESEARCH INSTITUTE · PI HUANG, ELBERT S., KARTER, ANDREW JOHN · 2016 to 2016
$773k
National Institute of Aging R01-AG051683National Institute of Aging R01-AG063391NCATS NIH HHS UL1 TR001863NIA NIH HHS R01 AG063391NIA NIH HHS R56 AG051683NIDDK NIH HHS P30 DK092924NIDDK NIH HHS P30-DK092924NIDDK NIH HHS P30 DK092949NIDDK NIH HHS R01 DK081796
6 · The paper itself

Abstract

backgroundSevere hypoglycemia is a serious adverse drug event associated with hypoglycemia-prone medications; older patients with diabetes are particularly at high risk. Economic food insecurity (food insecurity due to financial limitations) is a known risk factor for hypoglycemia; however, less is known about physical food insecurity (due to difficulty cooking or shopping for food), which may increase with age, and its association with hypoglycemia.

objectiveStudy associations between food insecurity and severe hypoglycemia.

designSurvey based cross-sectional study.

participantsSurvey responses were collected in 2019 from 1,164 older (≥ 65 years) patients with type 2 diabetes treated with insulin or sulfonylureas. MAIN MEASURES: Risk ratios (RR) for economic and physical food insecurity associated with self-reported severe hypoglycemia (low blood glucose requiring assistance) adjusted for age, financial strain, HbA1c, Charlson comorbidity score and frailty. Self-reported reasons for hypoglycemia endorsed by respondents. KEY

resultsFood insecurity was reported by 12.3% of the respondents; of whom 38.4% reported economic food insecurity only, 21.1% physical food insecurity only and 40.5% both. Economic food insecurity and physical food insecurity were strongly associated with severe hypoglycemia (RR = 4.3; p = 0.02 and RR = 4.4; p = 0.002, respectively). Missed meals ("skipped meals, not eating enough or waiting too long to eat") was the dominant reason (77.5%) given for hypoglycemia.

conclusionsHypoglycemia prevention efforts among older patients with diabetes using hypoglycemia-prone medications should address food insecurity. Standard food insecurity questions, which are used to identify economic food insecurity, will fail to identify patients who have physical food insecurity only.

Indexed as

Diabetes Mellitus, Type 2Food InsecurityHypoglycemiaHypoglycemic AgentsInsulinSulfonylurea CompoundsAgedAged, 80 and overCross-Sectional StudiesFemaleHumansMaleRisk FactorsHypoglycemic AgentsInsulinSulfonylurea Compounds

Identifiers

PMID38767746
PMCPMC11436613

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.