ABSTRACT
The primary aim of this study was to evaluate cardio-metabolic burden by insurance status for Hispanic/Latino adults in Santa Barbara, CA. HbA1c, body mass index (BMI), and health insurance status were evaluated via community-based screenings. Cardiovascular (CV) risk was assessed using the Framingham Heart Study calculator and compared with a National Health and Nutrition Examination Survey background population. Of 593 participants (73% female, age 47.3 years (SD ± 15.2), 44.5% had no insurance or did not know if they had insurance. 16% had an HbA1c in the diabetes range, comprised of 9% self-reporting diabetes and 7% self-reporting no diabetes. 39% had an HbA1c in the prediabetes range. Elevated HbA1c was associated with significantly higher BMI (p = 0.003) and lack of health insurance (p = 0.031). 10-year CV risk was significantly higher than the general population (p < 0.001). This program identified a high burden of cardio-metabolic disease and uninsurance coverage in Hispanic/Latino adults in Santa Barbara.
Subject(s)
Hispanic or Latino , Insurance Coverage , Adult , California/epidemiology , Female , Humans , Insurance, Health , Male , Middle Aged , Nutrition SurveysABSTRACT
Background: Food choices are essential to successful glycemic control for people with diabetes. We compared the impact of three carbohydrate-rich meals on the postprandial glycemic response in adults with type 1 diabetes (T1D). Methods: We performed a randomized crossover study in 12 adults with T1D (age 58.7 ± 14.2 years, baseline hemoglobin A1c 7.5% ± 1.3%) comparing the postprandial glycemic response to three meals using continuous glucose monitoring: (1) "higher protein" pasta containing 10 g protein/serving, (2) regular pasta with 7 g protein/serving, and (3) extra-long grain white rice. All meals contained 42 g carbohydrate; were served with homemade tomato sauce, green salad, and balsamic dressing; and were repeated twice in random order. After their insulin bolus, subjects were observed in clinic for 5 h. Linear mixed effects models were used to assess the glycemic response. Results: Compared with white rice, peak glucose levels were significantly lower for higher protein pasta (-32.6 mg/dL; 95% CI -48.4 to -17.2; P < 0.001) and regular pasta (-43.2 mg/dL, 95% CI -58.7 to -27.7; P < 0.001). The difference between the two types of pastas did not reach statistical significance (-11 mg/dL; 95% CI -24.1 to 3.4; P = 0.17). Total glucose area under the curve was also significantly higher for white rice compared with both pastas (P < 0.001 for both comparisons). Conclusions: This exploratory study concluded that different food types of similar macronutrient content (e.g., rice and pasta) generate significantly different postprandial glycemic responses in persons with T1D. These results provide useful insights into the impact of food choices on and optimization of glucose control. Clinical Trial Registry: clinicaltrials.gov NCT03362151.