{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T19:32:29Z","timestamp":1790364749072,"version":"4.1.0"},"reference-count":39,"publisher":"American Diabetes Association","issue":"8","license":[{"start":{"date-parts":[[2023,6,5]],"date-time":"2023-06-05T00:00:00Z","timestamp":1685923200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.diabetesjournals.org\/journals\/pages\/license"}],"funder":[{"DOI":"10.13039\/501100015739","name":"Diabetes Action Canada","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100015739","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100013899","name":"MSI Foundation","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100013899","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,8,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>To estimate the rates of diabetes complications and revascularization procedures among people with diabetes who have experienced homelessness compared with a matched cohort of nonhomeless control subjects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                    <jats:p>A propensity-matched cohort study was conducted using administrative health data from Ontario, Canada. Inclusion criteria included a diagnosis of diabetes and at least one hospital encounter between April 2006 and March 2019. Homeless status was identified using a validated administrative data algorithm. Eligible people with a history of homelessness were matched to nonhomeless control subjects with similar sociodemographic and clinical characteristics. Rate ratios (RRs) for macrovascular complications, revascularization procedures, acute glycemic emergencies, skin\/soft tissue infections, and amputation were calculated using generalized linear models with negative binomial distribution and robust SEs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Of 1,076,437 people who were eligible for inclusion in the study, 6,944 were identified as homeless. A suitable nonhomeless match was found for 5,219 individuals. The rate of macrovascular complications was higher for people with a history of homelessness compared with nonhomeless control subjects (RR 1.85, 95% CI 1.64\u20132.07), as were rates of hospitalization for glycemia (RR 5.64, 95% CI 4.07\u20137.81) and skin\/soft tissue infections (RR 3.78, 95% CI 3.31\u20134.32). By contrast, the rates of coronary revascularization procedures were lower for people with a history of homelessness (RR 0.76, 95% CI 0.62\u20130.94).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>These findings contribute to our understanding of the impact of homelessness on long-term diabetes outcomes. The higher rates of complications among people with a history of homelessness present an opportunity for tailored interventions to mitigate these disparities.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2337\/dc23-0211","type":"journal-article","created":{"date-parts":[[2023,6,5]],"date-time":"2023-06-05T16:31:21Z","timestamp":1685982681000},"page":"1469-1476","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":29,"title":["The Association of Homelessness With Rates of Diabetes Complications: A Population-Based Cohort Study"],"prefix":"10.2337","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7027-3723","authenticated-orcid":false,"given":"Ruchi","family":"Sharan","sequence":"first","affiliation":[{"name":"1Department of Medicine, University of Calgary, Calgary, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn","family":"Wiens","sequence":"additional","affiliation":[{"name":"2Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul E.","family":"Ronksley","sequence":"additional","affiliation":[{"name":"3Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen W.","family":"Hwang","sequence":"additional","affiliation":[{"name":"2Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada"},{"name":"4Li Ka Shing Knowledge Institute, St. Michael\u2019s Hospital, Toronto, Ontario, Canada"},{"name":"5ICES, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2769-6522","authenticated-orcid":false,"given":"Gillian L.","family":"Booth","sequence":"additional","affiliation":[{"name":"2Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada"},{"name":"4Li Ka Shing Knowledge Institute, St. Michael\u2019s Hospital, Toronto, Ontario, Canada"},{"name":"5ICES, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter C.","family":"Austin","sequence":"additional","affiliation":[{"name":"2Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada"},{"name":"5ICES, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eldon","family":"Spackman","sequence":"additional","affiliation":[{"name":"3Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Bai","sequence":"additional","affiliation":[{"name":"5ICES, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5570-3630","authenticated-orcid":false,"given":"David J.T.","family":"Campbell","sequence":"additional","affiliation":[{"name":"1Department of Medicine, University of Calgary, Calgary, Alberta, Canada"},{"name":"3Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada"},{"name":"6Department of Cardiac Sciences, University of Calgary, Calgary, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","published-online":{"date-parts":[[2023,6,5]]},"reference":[{"key":"2023072018563578900_B1","unstructured":"The White House . 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