Food insecurity is associated with Hypoglycemia and poor diabetes self-management in a low-income sample with diabetes

Hilary K. Seligman, Terry C. Davis, Dean Schillinger, Michael S. Wolf

Research output: Contribution to journalArticlepeer-review

133 Scopus citations

Abstract

More than 14% of the American population is food insecure, or at risk of going hungry because of an inability to afford food. Food-insecure (FI) adults often reduce food intake or substitute inexpensive, energy-dense carbohydrates for healthier foods. We hypothesized these behaviors would predispose FI adults with diabetes to hypoglycemia and impaired diabetes self-management. We therefore assessed whether food insecurity was associated with multiple indicators of diabetes self-management (self-efficacy, medication- and glucose-monitoring adherence, hypoglycemia, or glycemic control) among 40 low-income adults with diabetes. Mean self-efficacy score was lower among FI than food-secure (FS) participants (34.4 vs. 41.2, p5.02). Food-insecure participants reported poorer adherence to blood glucose monitoring (RR53.5, p5.008) and more hypoglycemia-related emergency department visits (RR52.2, p5.007). Mean hemoglobin A1c was 9.2% among FI and 7.7% among FS participants (p5.08). Food insecurity is a barrier to diabetes self-management and a risk factor for clinically significant hypoglycemia.

Original languageEnglish (US)
Pages (from-to)1227-1233
Number of pages7
JournalJournal of health care for the poor and underserved
Volume21
Issue number4
StatePublished - Nov 2010

Keywords

  • Diabetes
  • Hunger
  • Hypoglycemia
  • Self care

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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