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 Researchers found the likelihood of a person having poorly
controlled diabetes increased by about 39 percent for each of the
so-called economic insecurities they reported.
“What we found is that food and medication are a big deal and
probably account for the bulk of it, but it doesn’t look like there
is any one thing,” said Dr. Seth Berkowitz, the study’s lead author
from Massachusetts General Hospital in Boston.
Approximately 29 million Americans - about 9 percent of the U.S.
population - have diabetes, according to the Centers for Disease
Control and Prevention.
Type 2 is the most common form of diabetes and is often linked to
obesity. In type 2 diabetes, the body's cells may be resistant to
the hormone insulin, or the body may not make enough of the hormone.
Insulin gives blood sugar access to the body's cells to be used as
fuel.
There's been speculation that the 2010 Patient Protection and
Affordable Care Act – better known as Obamacare – would increase
access to healthcare for people with diabetes, Berkowitz and his
colleagues write in JAMA Internal Medicine.
People with low incomes may not benefit as much from that increased
access, they add, because getting more healthcare services does not
mean also having access to food, medications and other items needed
to control diabetes.
For the study, the researchers used data collected from June 2012
through October 2013 from 411 people with diabetes at clinics and
health centers in Massachusetts.
Massachusetts expanded healthcare access years before the rest of
the country.
“I think what we’re looking at in Massachusetts is where the rest of
the country will be in a few years,” Berkowitz said.
Most of the participants had insurance, about 46 percent of the
participants had uncontrolled diabetes and about 40 percent reported
some sort of inability to get food, medicine or other necessities.
Specifically, about 28 percent reported not taking their medicines
because they couldn’t afford the drugs. About 14 percent said they
couldn’t pay their utility bills, about 20 percent said they didn’t
have reliable access to food and about 11 percent said their housing
situation wasn’t stable.
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Food and medication insecurities were tied to poor control over
diabetes, the researchers found.
For example, about 64 percent of those who reported an unstable food
supply had uncontrolled diabetes, compared to about 42 percent of
those with food security.
While housing and energy insecurities were not tied to worse
diabetes control, the study found that people with an overall
greater number of insecurities had greater odds of being less in
control of their diabetes.
“I think it lets us know that even if we - nationwide - achieve the
rate of insurance coverage in Massachusetts, these problems will
still likely exist,” Berkowitz said.
He added that the problem is likely beyond the healthcare system to
solve, because the new research showed people with these
insecurities were visiting their doctors.
“You have people who are seeking care and seeing what they have, but
. . . you’re just not getting people what they need to stay
healthy,” Berkowitz said.
“This is sort of a policy or system-level issue,” he said. “I don’t
think there’s anything in the course of an individual visit that
patients or physicians are going to be able to do.”
Berkowitz added, though, that people should let their doctors and
healthcare providers know if they are experiencing any of these
difficulties.
SOURCE: http://bit.ly/1HbIWvu
JAMA Internal Medicine, online December 29, 2014.
[© 2014 Thomson Reuters. All rights
reserved.] Copyright 2014 Reuters. All rights reserved. This material may not be published,
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