Adverse Outcomes With Unmet Material Needs in Diabetes

Increasing number of unmet needs tied to increased odds of poor diabetes control, elevated resource use

MONDAY, Dec. 29, 2014 (HealthDay News) -- For adults with diabetes mellitus, unmet material needs are associated with poor diabetes control and increased health care resource use, according to a study published online Dec. 29 in JAMA Internal Medicine.

Seth A. Berkowitz, M.D., M.P.H., from Massachusetts General Hospital in Boston, and colleagues examined the correlation between material need insecurities and diabetes mellitus control and use of health care resources. Cross-sectional data were collected for a random sample of 411 adults (aged 21 years or older) with diabetes mellitus.

The researchers found that 39.1 percent of participants had at least one material need insecurity. Forty-six percent of participants had poor diabetes control. Food insecurity correlated with greater odds of poor diabetes control and increased outpatient visits, but not with increased emergency department/inpatient visits. Cost-related medication underuse correlated with poor diabetes control and increased emergency department/inpatient visits, but not with increased outpatient visits. Increased outpatient visits were seen with house instability and energy insecurity. Increases were seen in the odds of poor diabetes control (odds ratio for each additional need, 1.39; 95 percent confidence interval, 1.18 to 1.63) and health care resource use (adjusted incidence rate ratio for outpatient visits, 1.09 [95 percent confidence interval, 1.03 to 1.15] and for emergency department/inpatient visits, 1.22 [95 percent confidence interval, 0.99 to 1.51]) with an increasing number of insecurities.

"Material need insecurities may be important targets for improving care of diabetes mellitus," the authors write.

Abstract
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