Food insecurity is associated with hypoglycemia and poor diabetes self-management in a low-income sample with diabetes

J Health Care Poor Underserved. 2010 Nov;21(4):1227-33. doi: 10.1353/hpu.2010.0921.


More than 14% of the American population is food insecure, or at risk of going hungry because of an inability to afford food. Food-insecure (FI) adults often reduce food intake or substitute inexpensive, energy-dense carbohydrates for healthier foods. We hypothesized these behaviors would predispose FI adults with diabetes to hypoglycemia and impaired diabetes self-management. We therefore assessed whether food insecurity was associated with multiple indicators of diabetes self-management (self-efficacy, medication- and glucose-monitoring adherence, hypoglycemia, or glycemic control) among 40 low-income adults with diabetes. Mean self-efficacy score was lower among FI than food-secure (FS) participants (34.4 vs. 41.2, p=.02). Food-insecure participants reported poorer adherence to blood glucose monitoring (RR=3.5, p=.008) and more hypoglycemia-related emergency department visits (RR=2.2, p=.007). Mean hemoglobin A1c was 9.2% among FI and 7.7% among FS participants (p=.08). Food insecurity is a barrier to diabetes self-management and a risk factor for clinically significant hypoglycemia.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Blood Glucose Self-Monitoring / statistics & numerical data
  • Chicago / epidemiology
  • Diabetes Mellitus / therapy*
  • Emergency Service, Hospital / statistics & numerical data
  • Feeding Behavior / psychology*
  • Female
  • Follow-Up Studies
  • Food Supply / economics*
  • Glycated Hemoglobin A / analysis
  • Humans
  • Hunger
  • Hypoglycemia / epidemiology*
  • Louisiana / epidemiology
  • Male
  • Medication Adherence / statistics & numerical data
  • Poverty*
  • Risk Factors
  • Self Care / statistics & numerical data*
  • Self Efficacy


  • Glycated Hemoglobin A
  • hemoglobin A1c protein, human