Food Insecurity and Diabetes Self-Management among Youth and Young Adults with Type 1 Diabetes

Abstract

Background: Household food insecurity (FI) is associated with measures of diabetes self-management among older adults with diabetes. To our knowledge, there is no existing literature assessing this association among youth and young adults (YYA) with type 1 diabetes (T1D). Objective: To examine the association between FI and diabetes self-management, as measured by frequency of blood glucose monitoring and missed diabetes medication, among YYA with T1D. Methods: This is a cross-sectional study using data collected from 210 participants with T1D in South Carolina and Washington through the SEARCH for Diabetes in Youth study. FI was measured using the Household Food Security Survey Module and was scored 0-10 based on a continuous linear scale. Diabetes self-management was determined using two variables, frequency of glucose monitoring and missed medications, which were measured via health questionnaires. Results: We found that FI is significantly associated with frequency of missed diabetes medications, but not frequency of blood glucose monitoring. A one-unit increase in the standardized FI score was associated with a 24% increase in the odds of missing diabetes medication at least once per month (OR=1.24, 95% CI 1.02, 1.50, p=0.027). Socioeconomic status was significantly associated with frequency of blood glucose monitoring (OR=2.39, 95% CI 1.25, 4.56, p=0.008). Conclusion: These results suggest that FI is negatively associated with diabetes self-management as demonstrated by an increase in missed diabetes medication. Future studies are necessary to illuminate the relationship between FI and other self-management behaviors and examine the mechanisms through which FI may impact self-management.