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Food insecurity is associated with diabetes self‐care behaviours and glycaemic control
Author(s) -
Heerman W. J.,
Wallston K. A.,
Osborn C. Y.,
Bian A.,
Schlundt D. G.,
Barto S. D.,
Rothman R. L.
Publication year - 2016
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/dme.12896
Subject(s) - medicine , environmental health , diabetes mellitus , type 2 diabetes , food insecurity , randomized controlled trial , odds ratio , food security , gerontology , ecology , biology , agriculture , endocrinology
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 HbA 1c . 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 HbA 1c , 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.