The reported prevalence of food insecurity (FI), defined as the lack of consistent access to enough food for an active, healthy life, among Latino households is twice the national average. Using the U.S. Household Food Security Survey Module, we determined the prevalence, associated factors, and impact of FI on glycemic control among Latinos attending the Emory Latino Diabetes Education Program (ELDEP), a nationally accredited bilingual education program that provides free DSME classes for Latinos with low socioeconomic status in Atlanta, Georgia.
Results: Among 711 participants, a total of 295 (41.5%) were found to have FI. At baseline, there were no differences in age (50±11 vs. 50±12 years, p=0.86), gender (63% female vs. 68% male, p=0.18), BMI (31.4 vs. 31.3 kg/m2, p=0.64), insurance status (10% vs. 13%, p=0.85), annual household income <$20,000 (90% vs. 86%, p=0.40), or unemployment status (47% vs. 47%, p=0.88) between FI and non-FI patients. FI patients consumed fewer vegetables at their main meal, with 54% vs. 44% consuming <1/4 of a plate, respectively; p<0.03. Participants with FI had higher HbA1c (9.5±2.3% vs. 8.1±2.1%, p<0.001), higher rates of Spanish illiteracy (19% vs. 11%, p=0.005), lower English literacy level (9% vs. 14%, p=0.25), and a greater history of depression (36% vs. 26%, p=0.03). Despite higher HbA1c at baseline, Latinos with FI experienced a greater reduction in HbA1c at 3 months (-2.5±2.8% vs. -1.0±2.4%, p<0.06) and 6 months (-2.5±2.4% vs. -0.5±0.9%, p<0.01) of follow up compared to non-FI patients.
Conclusion: FI is common among Latino patients with type 2 diabetes in Georgia. Latino patients with FI significantly improved their diabetes control with access to our culturally sensitive Spanish diabetes education program. Diabetes education programs should be culturally tailored and individualized to take into consideration literacy, language fluency and food insecurity to improve diabetes self-management.
I.C. Flores: None. D. Porras Fimbres: None. J. Haw: None. A. Migdal: None. B. Rotberg: Employee; Self; Insulet Corporation, Novo Nordisk A/S. H. Wang: None. R.J. Galindo: Advisory Panel; Self; Abbott, Novo Nordisk Inc., Sanofi US. Research Support; Self; Novo Nordisk Inc. 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.