Food security is related to adult type 2 diabetes control over time in a United States safety net primary care clinic population.

BACKGROUND/OBJECTIVES: Successful Type 2 diabetes management requires adopting a high nutrient-density diet made up of food items that both meet dietary needs and preferences and can be feasibly obtained on a regular basis. However, access to affordable, nutrient-dense foods often is lacking in poorer neighbourhoods. Therefore, low food security should directly impair glucose control, even when patients have full access to and utilize comprehensive medical management. The present study sought to determine whether food security is related longitudinally to glucose control, over-and-above ongoing medication management, among Type 2 diabetes patients receiving comprehensive care at a Midwestern multi-site federally qualified health centre (FQHC). SUBJECTS/METHODS: In this longitudinal observational study, we completed a baseline assessment of patients' food security (using the US Household Food Security Module), demographics (via Census items), and diabetes history/management (using a structured clinical encounter form) when patients began receiving diabetes care at the health centre. We then recorded those patients' A1C levels several times during a 24-month follow-up period. Three hundred and ninety-nine patients (56% with low food security) had a baseline A1c measurement; a subsample of 336 (median age=52 years; 56% female; 60% Hispanic, 27% African American, and 9% White) also had at least one follow-up A1c measurement. RESULTS: Patients with lower (vs higher) food security were more likely to be on insulin and have higher A1c levels at baseline. Moreover, the disparity in glucose control by food security status persisted throughout the next 2 years. CONCLUSIONS: Although results were based on one multi-site FQHC, potentially limiting their generalizability, they seem to suggest that among Type 2 diabetes patients, low food security directly impairs glucose control-even when patients receive full access to comprehensive medical management-thereby increasing their long-term risks of high morbidity, early mortality, and high health-care utilization and cost.

Natural hybridization between parthenogenetic and bisexual lizards: detection of uniparental source of skin grafting.

Skin graft evidence is used to directly identify the unisexual parent of natural hybrids produced between the bisexual species Cnemidophorus inornatus and the unisexual Cnemidophorus neomexicanus. Reciprocal grafts transplanted among there suspected hybrids between Cnemidophorus inornatus and Cnemidophorus neomexicanus are rejected as well as grafts from the hybrids to C. neomexicanus, indicating that the hybrids are each genetically different from each other and that C. neomexicanus has the ability to reject foreign grafts. Allografts among C. neomexicanus and xenografts from C. neomexicanus to the hybrids are not rejected, indicating that C. neomexicanus is genetically homogeneous and that the hybrids possess genomes genetically identical to C. neomexicanus. Electrophoretic analysis of the hybrids and their probable parents supports the evidence obtained from skin grafting that C. neomexicanus is one of the parents, and suggests that C. inornatus, rather than C. tigris, is the bisexual parent. Chromosome spreads obtained from the hybrids reveal a triploid number of 69, a number consistent with their presumed origin from unreduced diploid ova (2N = 46) from C. neomexicanus and haploid serum (N = 23) from C. inornatus. Preliminary evidence is presented of the first hybrids known between Cnemidophorus inornatus and Cnemidophorus uniparens. Histological examination of the tests suggests that these hybrids are sterile. Included is a list summarizing all known hybrids between bisexual and unisexual species of the genus Cnemidophorus.