Association Between Neighborhood Supermarket Presence and Glycated Hemoglobin Levels Among Patients With Type 2 Diabetes Mellitus

Abstract

We estimated associations between neighborhood supermarket gain or loss and glycemic control (assessed by glycated hemoglobin (HbA1c) values) in patients from the Kaiser Permanente Northern California Diabetes Registry (n = 434,806 person-years; 2007-2010). Annual clinical measures were linked to metrics from a geographic information system for each patient's address of longest residence. We estimated the association between change in supermarket presence (gain, loss, or no change) and change in HbA1c value, adjusting for individual- and area-level attributes and according to baseline glycemic control (near normal, <6.5%; good, 6.5%-7.9%; moderate, 8.0%-8.9%; and poor, ≥9.0%). Supermarket loss was associated with worse HbA1c trajectories for those with good, moderate, and poor glycemic control at baseline, while supermarket gain was associated with marginally better HbA1c outcomes only among patients with near normal HbA1c values at baseline. Patients with the poorest baseline HbA1c values (≥9.0%) had the worst associated changes in glycemic control following either supermarket loss or gain. Differences were not clinically meaningful relative to no change in supermarket presence. For patients with type 2 diabetes mellitus, gaining neighborhood supermarket presence did not benefit glycemic control in a substantive way. The significance of supermarket changes on health depends on a complex interaction of resident, neighborhood, and store characteristics.

Ten‐year change in neighborhood socioeconomic status and colorectal cancer

“…11 Moreover, Zhang et al reported that loss of neighborhood supermarkets was related to worsening glycemic control after examining the data from the Kaiser Permanente Northern California Diabetes Registry. 12 Although the studies mentioned above did not examine the incidence of CRC, their findings suggested that changes in neighborhood conditions may be related to important risk factors for CRC, such as obesity, cardiometabolic health, and diet. 27 Contrary to our original hypothesis, we observed that an increase in neighborhood SES was not associated with a lower risk of CRC.…”

“…For example, using data from the Multi‐Ethnic Study of Atherosclerosis, Powell‐Wiley and colleagues reported that an improvement in neighborhood safety was linked to decreasing BMI for men . Moreover, Zhang et al reported that loss of neighborhood supermarkets was related to worsening glycemic control after examining the data from the Kaiser Permanente Northern California Diabetes Registry . Although the studies mentioned above did not examine the incidence of CRC, their findings suggested that changes in neighborhood conditions may be related to important risk factors for CRC, such as obesity, cardiometabolic health, and diet …”

“…Moreover, several previous studies have linked long‐term trajectories or changes in neighborhood conditions with CRC risk factors. For example, an improvement in neighborhood safety was linked to a decrease in body‐mass index (BMI), and loss of neighborhood supermarkets was related to worsening glycemic control . Several studies have suggested indirectly that improved neighborhood environment, such as an improved physical environment or exposure to a better socioeconomic environment after moving, may affect BMI .…”

“…For example, an improvement in neighborhood safety was linked to a decrease in body-mass index (BMI), 11 and loss of neighborhood supermarkets was related to worsening glycemic control. 12 Several studies have suggested indirectly that improved neighborhood environment, such as an improved physical environment or exposure to a better socioeconomic environment after moving, may affect BMI. [13][14][15] Therefore, it is plausible to hypothesize that changes in neighborhood conditions may play a role in CRC risk.…”

Food Insecurity, Food “Deserts,” and Glycemic Control in Patients With Diabetes: A Longitudinal Analysis

“…There have been few previous studies of physical food access and HbA 1c . One study in the San Francisco Bay Area found that losing or gaining a supermarket in a neighborhood was not associated with meaningful change in HbA 1c (30). Prior studies of BMI and neighborhood food access in patients with diabetes also have generally not found an important association (31)(32)(33).…”