Household food insecurity and higher blood glucose levels among Latinos with type 2 diabetes

INTRODUCTION: Household food insecurity (HFI) is prevalent among low-income Latinos with type 2 diabetes (T2D). We examined the association between HFI and blood glucose control in this population. APPROACH: We conducted a cross-sectional analysis of baseline data (N=97) of the ongoing stress management CALMS-D trial. Participants were recruited from a metabolic clinic if they had T2D without major complications, were Latino, lived in the Hartford, CT area, and had poor glucose control (HbA1c of 7 or higher). HFI was measured with a 5-item version of the US Household food Security Survey Module (Cronbach alpha=0.87). Based on their HFI summative score, households were classified as either food secure or into three levels of food insecurity. Fasting blood samples were collected in the participant’s homes to assess glycemic and lipid control biomarkers including blood glucose. Multivariate linear regression analyses were conducted to assess the independent association of HFI with blood glucose after adjusting for socio-economic and demographic confounders (Model R²=0.23). RESULTS: HFI showed a significant (p=0.001) dose response association with blood glucose levels after adjusting for participant’s age, gender, education, and marital status, and household income. The adjusted blood glucose means (SD) across HFI categories were: food secure, 145.5 (17.4);  mild food insecure, 170.7 (21.3); moderate food insecure, 184.0 (19.6); severe food insecure, 204.4 (21.7) mg/dl. CONCLUSIONS: HFI is a risk factor for higher blood glucose among Latinos with poorly controlled T2D. Providers that serve disadvantaged populations with T2D should consider routinely screening for HFI.