Matthew M. Ippolito|Courtney R. Lyles|Kimberly Prendergast|Michelle Marshall|Elaine Waxman|Hilary K. Seligman
Food insecurity and diabetes self-management among food pantry clients
Johns Hopkins Medicine|Johns Hopkins University|University of California, San Francisco|San Francisco General Hospital|Feeding America|Feeding America|Urban Institute|University of California, San Francisco|San Francisco General Hospital
abstract objective examine association level food security diabetes selfmanagement among food pantry clients largely possible using clinicbased sampling methods design crosssectional descriptive study setting communitybased food pantries california ohio texas usa march 2012 march 2014 subjects convenience sample adults diabetes queuing pantries n 1237 83 response sampled adults stratified food secure low food secure low food secure used pointofcare glycated hb hba 1c testing determine glycaemic control captured diabetes selfmanagement using validated survey items results sample 70 female 55 latinohispanic 25 white 10 blackafrican american mean age 56 years eightyfour per cent food insecure onehalf low food security mean hba 1c 81 vary significantly food security status adjusted models verylowfoodsecure participants compared lowfoodsecure foodsecure participants poorer diabetes selfefficacy greater diabetes distress greater medication nonadherence higher prevalence severe hypoglycaemic episodes higher prevalence depressive symptoms medication affordability challenges food medicine health supply tradeoffs conclusions studies health impact food security able examine low food security food pantry sample high rates food insecurity found diabetes selfmanagement becomes increasingly difficult food security worsens efficacy interventions improve diabetes selfmanagement may increase food security simultaneously addressed