Food insecurity is associated with hypoglycemia and poor diabetes self-management in a low-income sample with diabetes
Open accessAbstract
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, p=.02). Food-insecure participants reported poorer adherence to blood glucose monitoring (RR=3.5, p=.008) and more hypoglycemia-related emergency department visits (RR=2.2, p=.007). Mean hemoglobin A1c was 9.2% among FI and 7.7% among FS participants (p=.08). Food insecurity is a barrier to diabetes self-management and a risk factor for clinically significant hypoglycemia.
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Selvamani, Y., Perianayagam, A., & Chaudhary, M. (2023) · Archives of Gerontology and Geriatrics · doi:10.1016/j.archger.2023.105079 · Cited by 31 · see citing works
Food Insecurity and the Nutrition Care Process: Practical Applications for Dietetics Practitioners
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Primary Care Providers’ Perspectives on Screening Older Adult Patients for Food Insecurity
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Food Insecurity Among Veterans: Resources to Screen and Intervene.
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Time to eat? The relationship between food security and food-related time use
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- Authors
- Seligman, H. K., Davis, T. C., Schillinger, D., & Wolf, M. S.
- Affiliations
- University of California, San Francisco (US)
- Louisiana State University (US)
- San Francisco General Hospital (US)
- Northwestern University (US)
- Venue
- Journal of Health Care for the Poor and Underserved
- Publisher
- Project MUSE
- Published
- 2010-11
- Volume
- 21
- Issue
- 4
- Pages
- 1227-1233
- ISSN
- 1049-2089 (ISSN-L)
- 1548-6869
- PMC
- PMC3004431
- OpenAlex
- W1530193861
- Cited by
- 267
- References
- 14
- Citations by year
- 2026: 12 · 2025: 9 · 2024: 13 · 2023: 19 · 2022: 25 · 2021: 19 · 2020: 31 · 2019: 20 · 2018: 19 · 2017: 25 · 2016: 12 · 2015: 27 · 2014: 11 · 2013: 16 · 2012: 7
- FWCI
- 14.20
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Health Care for the Poor and Underserved (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Project Muse (Johns Hopkins University) (submittedVersion)
- Funders
- National Institutes of Health
- National Center for Research Resources (KL2RR024130)
- Topics
- Health Sciences › Health Professions › General Health Professions › Food Security and Health in Diverse Populations
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- food insecurity, diabetes mellitus, hypoglycemia, diabetes self-management, low-income adults, self-efficacy, medication adherence, blood glucose monitoring, glycemic control, HbA1c, emergency department visits
- MeSH terms
- Adult, Chicago, Diabetes Mellitus, Emergency Service, Hospital, Feeding Behavior, Female, Follow-Up Studies, Food Supply, Glycated Hemoglobin, Humans, Hunger, Hypoglycemia, Louisiana, Male, Poverty, Risk Factors, Self Care, Blood Glucose Self-Monitoring, Drug Monitoring, Self Efficacy
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