Food insecurity (FI), or the uncertain or limited availability of nutritious food, disproportionately affects lower income and minority populations. To determine the prevalence and impact of food insecurity in non-Hispanic African American (AA) patients with diabetes (DM) in an urban safety-net diabetes clinic, we conducted a prospective, comprehensive analysis using validated surveys measuring FI severity, education, mental health, and socioeconomic factors. Parameters of glycemic control and DM complications were collected from the electronic medical record. Factors contributing to food insecurity and clinical outcomes were compared by food security status.
Among 243 AA patients surveyed, 53% of patients had FI. More FI patients had low income and gaps in insurance. FI patients also had worse self-reported physical and mental health, more complications of DM, and more hypoglycemia. Despite having more complications and hypoglycemia, there were no significant differences in glycemic control (HbA1c 8.7% ± 2.5 vs. 8.7% ± 2.3, p=0.88) or insulin use (75% vs. 74%, p=0.92) between patients with and without FI.
Our results indicate that FI affects over half of inner-city AA patients with DM and is associated with higher rates of diabetic complications, hypoglycemia and a lower quality of life. FI represents a common and significant challenge in treating low-income AA patients with DM.
K.L. Flint: None. G. Davis: None. L. Peng: None. S.H. Campbell: None. G.E. Umpierrez: Advisory Panel; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Janssen Pharmaceuticals, Inc. Research Support; Self; AstraZeneca, Merck & Co., Inc., Novo Nordisk Inc., Sanofi US.