Food insecurity and diabetes self-management among food pantry clients

Matthew M. Ippolito, Courtney R. Lyles, Kimberly Prendergast, Michelle Berger Marshall, Elaine Waxman, Hilary Kessler Seligman

Research output: Contribution to journalArticle

Abstract

Objective: To examine the association between level of food security and diabetes self-management among food pantry clients, which is largely not possible using clinic-based sampling methods. Design: Cross-sectional descriptive study. Setting: Community-based food pantries in California, Ohio and Texas, USA, from March 2012 through March 2014. Subjects: Convenience sample of adults with diabetes queuing at pantries (n 1237; 83 % response). Sampled adults were stratified as food secure, low food secure or very low food secure. We used point-of-care glycated Hb (HbA1c) testing to determine glycaemic control and captured diabetes self-management using validated survey items. Results: The sample was 70 % female, 55 % Latino/Hispanic, 25 % white and 10 % black/African American, with a mean age of 56 years. Eighty-four per cent were food insecure, one-half of whom had very low food security. Mean HbA1c was 8·1 % and did not vary significantly by food security status. In adjusted models, very-low-food-secure participants, compared with both low-food-secure and food-secure participants, had poorer diabetes self-efficacy, greater diabetes distress, greater medication non-adherence, higher prevalence of severe hypoglycaemic episodes, higher prevalence of depressive symptoms, more medication affordability challenges, and more food and medicine or health supply trade-offs. Conclusions: Few studies of the health impact of food security have been able to examine very low food security. In a food pantry sample with high rates of food insecurity, we found that diabetes self-management becomes increasingly difficult as food security worsens. The efficacy of interventions to improve diabetes self-management may increase if food security is simultaneously addressed.

Original languageEnglish (US)
Pages (from-to)183-189
Number of pages7
JournalPublic health nutrition
Volume20
Issue number1
DOIs
StatePublished - Jan 1 2017

Keywords

  • Diabetes self-management
  • Food pantries
  • Food security

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics
  • Public Health, Environmental and Occupational Health

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  • Cite this

    Ippolito, M. M., Lyles, C. R., Prendergast, K., Marshall, M. B., Waxman, E., & Seligman, H. K. (2017). Food insecurity and diabetes self-management among food pantry clients. Public health nutrition, 20(1), 183-189. https://doi.org/10.1017/S1368980016001786