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Diabet Med. 2016 Jun;33(6):844-50. doi: 10.1111/dme.12896. Epub 2015 Oct 15.

Food insecurity is associated with diabetes self-care behaviours and glycaemic control.

Author information

1
Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA.
2
Vanderbilt Center for Diabetes Translation Research, Center for Diabetes and Translational Research, Vanderbilt University, Nashville, TN, USA.
3
Vanderbilt Center for Health Services Research, Nashville, TN, USA.
4
School of Nursing, Nashville, TN, USA.
5
Department of Biomedical Informatics and the Center for Health Behavior and Health Education, Nashville, TN, USA.
6
Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
7
Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA.
8
Department of Psychology, Vanderbilt University, Nashville, TN, USA.

Abstract

AIMS:

Food insecurity is the 'limited or uncertain availability of nutritionally adequate and safe foods'. Our objective was to examine the association between food insecurity, diabetes self-care and glycaemic control.

METHODS:

We conducted a cross-sectional analysis of baseline data from adult patients with Type 2 diabetes who were enrolled in a randomized trial evaluating a health literacy-focused diabetes intervention in safety net primary care clinics in middle Tennessee. Food insecurity was assessed with three items from the U.S. Household Food Security Survey. Diabetes self-care behaviours were assessed with the Summary of Diabetes Self-Care Activities Scale, Personal Diabetes Questionnaire and Adherence to Refills and Medication Scale. Glycaemic control was assessed with HbA1c .

RESULTS:

The sample consisted of 401 participants, 73% of whom reported some level of food insecurity. Food insecurity was significantly associated with self-care behaviours including less adherence to a general diet [Adjusted Odds Ratio (AOR) 0.9, P = 0.02], less physical activity (AOR 0.9, P = 0.04) and with a greater occurrence of medication non-adherence (AOR 1.2, P = 0.002) and calorie restriction (AOR 1.1, P = 0.02). Food insecurity was also associated with worse glycaemic control (adjusted β = 0.1, P = 0.03). None of the self-care behaviours were significantly associated with HbA1c , limiting the ability to test for self-care as a mechanism linking food insecurity to glycaemic control.

CONCLUSIONS:

There was a high rate of food insecurity in a sample of patients with Type 2 diabetes who were of low socio-economic status. Food insecurity was associated with less adherence to recommended self-care behaviours and worse glycaemic control.

PMID:
26314941
PMCID:
PMC4769979
DOI:
10.1111/dme.12896
[Indexed for MEDLINE]
Free PMC Article

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