2284-PUB: Food Insecurity and Autonomic Dysfunction among Latinos with Type 2 Diabetes

Abstract

Aims: Food insecurity (FI) is higher among Latinos than non-Hispanic Whites and associated with risk for type 2 diabetes (T2D). Autonomic nervous system (ANS) dysfunction increases mortality in diabetes. We examined FI and ANS function among Low-income Latinos with T2D enrolled in a parent stress management trial.Methods: Inclusion: age > 18 years, Latino or Hispanic, Spanish speaking, ambulatory status, T2D > 6 months, A1c>7.0%. Exclusion: medical or psychiatric instability; pain or dysfunction in hands precluding handgrip testing.Measures: FI was assessed with the 6-item U.S. household food security survey module; affirmative responses to >=1 question was coded as FI. Six autonomic measures were scored 0=normal or 1=abnormal based on published cutoffs and then summed for a total ANS dysfunction index. ANS measures and their normal cutoffs were: 1) metanephrine <350 ug/day; 2) normetanephrine <600 ug/day; 3) cortisol 50-190 ug/day, all from 24-hour urine specimens; 4) 24-hour heart rate variability as reflected in standard deviation of the normal-to-normal (SDNN) heart rate acquired with 3-channel, 7-lead ambulatory electrocardiogram (holter) monitors, 149 +/-39; 5) difference between the highest diastolic blood pressure (DBP) during sustained handgrip and the average DBP at rest, >15 mmHg; and, 6) difference between baseline supine and the minimal BP after standing up, normal = decline in SBP