Cited by 268Food Security and Health in Diverse PopulationsDiabetes Management and EducationDiabetes Management and Research

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Food Insecurity is Associated with Hypoglycemia and Poor Diabetes Self-Management in a Low-Income Sample with Diabetes

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Seligman, Hilary K., Davis, Terry C., Schillinger, Dean, Wolf, Michael S.·2010·Journal of Health Care for the Poor and Underserved

DOI 10.1353/hpu.2010.0921PMC PMC3004431

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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, 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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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)
ORCID: Seligman, Hilary K.
Davis, Terry C.
Schillinger, Dean
Wolf, Michael S.
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
DOI: 10.1353/hpu.2010.0921
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 › Medicine › Public Health, Environmental and Occupational Health › 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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Food Insecurity is Associated with Hypoglycemia and Poor Diabetes Self-Management in a Low-Income Sample with Diabetes

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