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Household food insecurity is associated with higher insulin resistance and blood glucose levels in Latinos with type 2 diabetes
Author(s) -
BermúdezMillán Angela,
Wagner Julie A,
SeguraPérez Sofia,
Damio Grace,
Chhabra Jyoti,
PérezEscamilla Rafael
Publication year - 2016
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.30.1_supplement.899.4
Subject(s) - medicine , insulin resistance , type 2 diabetes , food security , diabetes mellitus , population , food insecurity , insulin , body mass index , demography , endocrinology , environmental health , biology , ecology , sociology , agriculture
Household food insecurity (HFI) is associated with chronic diseases, including diabetes, among lower income Latinos. We examined the associations between HFI and blood glucose levels and insulin resistance in this population. APPROACH We studied a sample of 120 Latinos with type 2 diabetes who completed baseline assessments for the CALMS‐D stress management trial. HFI was measured with a 5‐item version of the US Household Food Security Survey Module (Cronbach alpha=0.87). Households were classified as either food secure, mild/moderate food insecure, or severe food insecure. We also categorized individuals as food secure versus food insecure. Fasting glucose and insulin levels were measured and the log‐transformed HOMA‐IR values were used for analyses. RESULTS Mean age was 61 years, 74% were female and mean HbA1c was 8.6%. Analysis of variance showed a significant (p<0.001) dose‐response association between fasting blood glucose levels and HFI severity before and after adjusting for gender, education, household income, body mass index and insulin use. The adjusted blood glucose means (SE) across HFI categories were: food secure, 144.8 (8.5); mild/moderate food insecure, 175.8 (7.2); severe food insecure, 200.5 (10.9) mg/dl. When HFI was dichotomized as food secure vs insecure, a significant relationship (p<.05) was found for logHOMA‐IR before and after adjusting for covariates. The untransformed HOMA‐IR adjusted means (SE) were: food secure, 8.9 (2.0); food insecure, 15.0 (1.4). CONCLUSIONS Fasting blood glucose and insulin resistance are associated with HFI among Latinos with diabetes. Food insecure individuals had higher fasting glucose and more severe insulin resistance than food secure individuals. Providers that serve disadvantaged populations with type 2 diabetes should consider routinely screening for HFI. Support or Funding Information This work is supported by: Stress Management Among Latinos With Type 2 Diabetes (CALMS‐D) (NIMHD R01MD005879‐01).