142nd APHA Annual Meeting and Exposition

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300983
Household food insecurity and higher blood glucose levels among Latinos with type 2 diabetes

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014 : 8:30 AM - 8:50 AM

Rafael Perez-Escamilla, Ph.D. , Yale School of Public Health, New Haven, CT
Angela Bermudez-Millan, Ph.D., M.P.H. , Division of Behavioral Sciences and Community Health, School of Dental Medicine, UCONN Health Center, Farmington, CT
Sofia Segura-Perez, M.S., R.D. , Center for Community Nutrition, Hispanic Health Council, Hartford, CT
Grace Damio, M.S., CD/N , Director of Research and Service Initiatives, Hispanic Health Council, Hartford, CT
Jyoti Chhabra, Ph.D. , Research Administration, Hartford Hospital, Hartford, CT
Julie Wagner, Ph.D. , Division of Behavioral Sciences and Community Health, School of Dental Medicine, UCONN Health Center, Farmington, CT
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.

Learning Areas:

Advocacy for health and health education
Assessment of individual and community needs for health education
Chronic disease management and prevention
Planning of health education strategies, interventions, and programs
Public health or related public policy
Public health or related research

Learning Objectives:
Describe the higher risk of poor blood glucose control among Latinos with type 2 diabetes as a function of household food insecurity severity.

Keyword(s): Diabetes, Food Security

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a PI of the study, took the leadership with study design, data analyses, and abstract write up. The topic being addressed is along standing component of my research portfolio.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.