TY - JOUR
T1 - Food insecurity and diabetes self-management among food pantry clients
AU - Ippolito, Matthew M.
AU - Lyles, Courtney R.
AU - Prendergast, Kimberly
AU - Marshall, Michelle Berger
AU - Waxman, Elaine
AU - Seligman, Hilary Kessler
N1 - Funding Information:
This work was supported by NIH/NCRR/OD UCSF-CTSI Grant Number KL2 RR024130, AHRQ Career Development Award R00HS022408, and The Bristol-Myers Squibb Foundation. Research reported in this publication was supported by the National Institute of General Medical Sciences of the National Institutes of Health under award number T32GM066691.
Publisher Copyright:
© The Authors 2016.
PY - 2017/1/1
Y1 - 2017/1/1
N2 - 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.
AB - 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.
KW - Diabetes self-management
KW - Food pantries
KW - Food security
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U2 - 10.1017/S1368980016001786
DO - 10.1017/S1368980016001786
M3 - Article
C2 - 27406399
AN - SCOPUS:84978168396
SN - 1368-9800
VL - 20
SP - 183
EP - 189
JO - Public health nutrition
JF - Public health nutrition
IS - 1
ER -