Food insecurity, a modifiable risk factor, has a significant impact on individuals' health and well-being. This study examined the association between food insecurity and glycemic goals among Medicare beneficiaries aged ≥65 years with type 2 diabetes (T2D) , using the 20Medicare Current Beneficiary Survey (n=1,340) . The binary dependent variable was whether beneficiaries' blood glucose (BG) was at target (i.e., having A1C ≤7.5% or average fasting BG of ≤140 mg/dL, all/most of the time) . Food insecurity, a binary variable, was defined as having ≥2 affirmative responses on 4 selected questions of the USDA's food security questionnaire. A survey-weighted multivariable logistic model, adjusted for socio-demographics and comorbidities, was conducted to estimate predictive margins for comparing prevalence of having higher than target BG levels across groups. Of study beneficiaries with T2D, 20.9% reported not achieving glycemic targets. Beneficiaries not meeting BG goals were more likely to be: female (60.5% vs. 49.1%, p=0.002) , less educated (<high school, 21.9% vs. 13.4%, p=0.013) , and experiencing food insecurity (20.4% vs. 8.9%, p<0.001) . In the adjusted analysis, the predictive marginal prevalence of having higher than target BG levels was significantly greater in females over males (23.8% [95% CI, 20.0-27.5] vs. 16.6% [13.4-19.8]) ; those with less than high school education over those with greater education (30.9% [23.6-38.3] vs. 18.5% [14.7-22.3]) ; and those reporting food insecurity over their counterparts (33.4% [24.5-42.3] vs. 19.1% [16.5-21.6]) . This study identified that females, those with low education levels, and those experiencing food insecurity may be less likely to achieve BG goals, placing them at-risk of developing potentially preventable complications and incurring higher overall healthcare costs. Routine screening and interventions to reduce these disparities should be considered by all healthcare team members caring for Medicare beneficiaries with T2D.


B.Ng: None. M.P.Stewart: None. J.B.Lamanna: None. C.Park: None.

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