BACKGROUND: Social risk factors for hypoglycemia are not well understood. METHODS: Cross-sectional analysis from the DISTANCE study, a multi-language, ethnically-stratified random sample of adults in the Kaiser Permanente Northern California diabetes registry, conducted in 2005-2006 (response rate 62%). Exposures were income and educational attainment; outcome was patient report of severe hypoglycemia. To test the association, we used multivariable logistic regression to adjust for demographic and clinical factors. RESULTS: 14,357 patients were included. Reports of severe hypoglycemia were common (11%), and higher in low-income vs. high-income (16% vs. 8.8) and low-education vs. high-education (11.9% vs. 8.9%) groups. In multivariable analysis, incomes of less than $15,000 (OR 1.51 95%CI 1.19-1.91), $15,000-$24,999 (OR 1.57 95%CI 1.27-1.94), and high school or less education (OR 1.42, 95% CI 1.24-1.63) were associated with increased hypoglycemia, similar to insulin use (OR 1.44 95%CI 1.19-1.74). CONCLUSIONS: Low income and educational attainment are important risk factors for hypoglycemia.
BACKGROUND: Social risk factors for hypoglycemia are not well understood. METHODS: Cross-sectional analysis from the DISTANCE study, a multi-language, ethnically-stratified random sample of adults in the Kaiser Permanente Northern California diabetes registry, conducted in 2005-2006 (response rate 62%). Exposures were income and educational attainment; outcome was patient report of severe hypoglycemia. To test the association, we used multivariable logistic regression to adjust for demographic and clinical factors. RESULTS: 14,357 patients were included. Reports of severe hypoglycemia were common (11%), and higher in low-income vs. high-income (16% vs. 8.8) and low-education vs. high-education (11.9% vs. 8.9%) groups. In multivariable analysis, incomes of less than $15,000 (OR 1.51 95%CI 1.19-1.91), $15,000-$24,999 (OR 1.57 95%CI 1.27-1.94), and high school or less education (OR 1.42, 95% CI 1.24-1.63) were associated with increased hypoglycemia, similar to insulin use (OR 1.44 95%CI 1.19-1.74). CONCLUSIONS: Low income and educational attainment are important risk factors for hypoglycemia.
Authors: Howard H Moffet; Nancy Adler; Dean Schillinger; Ameena T Ahmed; Barbara Laraia; Joe V Selby; Romain Neugebauer; Jennifer Y Liu; Melissa M Parker; Margaret Warton; Andrew J Karter Journal: Int J Epidemiol Date: 2008-03-07 Impact factor: 7.196
Authors: Urmimala Sarkar; Andrew J Karter; Jennifer Y Liu; Howard H Moffet; Nancy E Adler; Dean Schillinger Journal: J Gen Intern Med Date: 2010-05-18 Impact factor: 5.128
Authors: Hilary K Seligman; Elizabeth A Jacobs; Andrea Lopez; Urmimala Sarkar; Jeanne Tschann; Alicia Fernandez Journal: Arch Intern Med Date: 2011-07-11
Authors: Kristine Yaffe; Cherie M Falvey; Nathan Hamilton; Tamara B Harris; Eleanor M Simonsick; Elsa S Strotmeyer; Ronald I Shorr; Andrea Metti; Ann V Schwartz Journal: JAMA Intern Med Date: 2013-07-22 Impact factor: 21.873
Authors: Silvio E Inzucchi; Richard M Bergenstal; John B Buse; Michaela Diamant; Ele Ferrannini; Michael Nauck; Anne L Peters; Apostolos Tsapas; Richard Wender; David R Matthews Journal: Diabetes Care Date: 2012-04-19 Impact factor: 19.112
Authors: Andrew J Karter; Kasia J Lipska; Patrick J O'Connor; Jennifer Y Liu; Howard H Moffet; Emily B Schroeder; Jean M Lawrence; Gregory A Nichols; Katherine M Newton; Ram D Pathak; Jay Desai; Beth Waitzfelder; Melissa G Butler; Abraham Thomas; John F Steiner Journal: J Diabetes Complications Date: 2017-02-21 Impact factor: 2.852
Authors: Andrew J Karter; E Margaret Warton; Kasia J Lipska; James D Ralston; Howard H Moffet; Geoffrey G Jackson; Elbert S Huang; Donald R Miller Journal: JAMA Intern Med Date: 2017-10-01 Impact factor: 21.873
Authors: Mark C Pachucki; Andrew J Karter; Nancy E Adler; Howard H Moffet; E Margaret Warton; Dean Schillinger; Bethany Hendrickson O'Connell; Barbara Laraia Journal: Appetite Date: 2018-03-27 Impact factor: 3.868