Rise in hunger drives up hypoglycemia hospital admissions

Hunger in the United States may have important health consequences, including a higher risk of low blood sugar, a new study suggested.

One in 7 US households cannot reliably afford food. Food budgets are more frequently exhausted at the end of a month than at other points in time. 

Hilary K. Seligman, MD, MAS, of the University of California, San Francisco, and study coauthors postulated that this could influence health outcomes, such as heightened risk for hypoglycemia among people with diabetes. 

The authors examined administrative data on inpatient admissions in California for 2000 to 2008 and found that among low-income Californians, risk for hypoglycemia admission increased 27% in the last week of a month compared to the first week of the month; no similar temporal pattern existed for the high-income population. The authors conclude that exhausted food budgets late in the month might also influence admission patterns for other diet-sensitive diseases, such as congestive heart failure. This is one of the first studies-perhaps the very first-to study the link between exhausted food budgets and disease increase at the end of the month.

The number of admissions in the low-income population for hypoglycemia was 240 per 100,000 total admissions in the first week of the month, 260 in the second week of the month, 290 in the third week of the month, and 300 in the last week of the month. In the high-income sample, the number of admissions for hypoglycemia was 190-200 per 100,000 total admissions across all weeks of the month.

“As a control, we also looked at within-month patterns of an income-neutral condition: appendicitis.  We did not observe a similar pattern for appendicitis,” said Dr Seligman, assistant professor of medicine and of epidemiology and biostatistics division of general internal medicine, University of California San Francisco, Center for Vulnerable Populations at San Francisco General Hospital.

“There is a hidden epidemic of hunger in the United States, with 1 in 7 Americans worrying that they will not have enough money for food,” she told FormularyWatch. “This data show that our epidemic of hunger has serious health consequences. Potentially preventable admissions like the ones we documented have important consequences for the individuals who are admitted to the hospitals, but also to health systems and payers who have to finance healthcare costs that could be avoided.”

While Dr Seligman and her colleagues cannot definitively say that the rise in hypoglycemia admissions in the low-income population is related to running out of money for food, “our data is highly suggestive,” she said. “Stable food intake is important for good health, particularly for patients with diabetes.  When money runs out at the end of the month and the budget for food is compromised among those with limited incomes, the consequence appears to be more admissions to the hospital for low blood sugar.”