Food Insecurity, Residential Racial Segregation Linked to Diabetes Outcomes

Two new[1] studies presented[2] at the 2022 Scientific Sessions of the American Diabetes Association (ADA) highlight the effects that social conditions can have on diabetes outcomes, according to a news release[3] from the organization.

Social determinants of health — factors like your income level, your neighborhood’s safety and walkability, and your race and ethnicity — can affect a wide range of health outcomes, including some related to diabetes. Previous studies have shown that Black children with type 1 diabetes[4] — especially those who live in poorer neighborhoods — are at greater risk for readmission to the hospital for diabetic ketoacidosis (DKA)[5], a medical emergency marked by very high blood glucose. Adults who live near fast food restaurants are at greater risk for developing type 2 diabetes[6], highlighting how your food environment typically affects the quality of your diet. And living in areas with greater air pollution puts you at higher risk for developing type 2 diabetes[7] — including if you’re a child[8].

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Social factors linked to diabetes risk, worse diabetes management

One of the latest studies presented at the ADA conference looked at the effects of both food insecurity and diet quality on developing type 2 diabetes[10] in adults. Food insecurity means not having reliable access to nutritious foods, and is separate from diet quality — the nutrition content of the foods that you actually eat. In a nationally representative sample of adults with diabetes, 15.3% were found to be living below the federal poverty threshold. An even greater proportion, 19.3%, reported experiencing food insecurity, and survey responses about diet indicated that 50.7% had a low diet quality. Both food insecurity and diet quality were linked to two diabetes related outcomes — A1C level[11] (a measure of long-term blood glucose control) and low HDL[12] (high-density lipoprotein, or “good”) cholesterol combined with high triglycerides[13] (a type of blood fat). But there was a stronger link between food insecurity and these health outcomes, compared with diet quality.

“Food insecurity has a strong impact on people with diabetes, particularly for people from racial and ethnic groups already experiencing health disparities,” said study author Jean M. Lawrence, ScD, program director at the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), in the news release. “We hope these results encourage health care providers to include a food insecurity assessment as part of their overall diabetes treatment.”

The second study presented at the ADA conference looked at the effect of neighborhood racial segregation on diabetes control in Black youth with type 1 diabetes, whose average age was about 13. Looking at various neighborhood factors among 144 study participants living in Chicago and Detroit, the researchers found that youth who lived in more segregated neighborhoods — those with less racial diversity, which in this study meant being predominantly Black — had worse diabetes control, as shown by several difference measurements (including A1C) combined to create a score on what’s known as the Diabetes Management Scale. This was true even after the researchers adjusted for participants’ family income and “neighborhood adversity,” such as crime and poverty — living in a more segregated neighborhood meant worse diabetes control.

“Our findings indicate that persistent residential segregation is contributing to health inequity for U.S. children with diabetes,” said study author Deborah Ellis, PhD, a professor of family medicine and public health sciences at Wayne State University in Detroit. “This reinforces the need for health care providers to screen for and address social determinants of health in order to effectively address children’s care needs, as we work to reduce the burden of type 1 diabetes nationwide.”

Want to learn more about food insecurity and resources for affording food? Read “Six Ways to Save Money on Groceries”[14] and “Resources for Affording Food.”[15] 

Endnotes:
  1. Two new: https://eppro02.ativ.me/src/EventPilot/php/express/web/page.php?page=IntHtml&project=ADA22&id=1494
  2. studies presented: https://eppro02.ativ.me/src/EventPilot/php/express/web/page.php?page=IntHtml&project=ADA22&id=443
  3. news release: https://diabetes.org/sites/default/files/2022-06/ADA%2022%20Bundled%20Health%20Disparities%20Press%20Release_%20FINAL.pdf
  4. type 1 diabetes: https://www.diabetesselfmanagement.com/diabetes-resources/definitions/type-1-diabetes/
  5. greater risk for readmission to the hospital for diabetic ketoacidosis (DKA): https://www.diabetesselfmanagement.com/news-research/2022/05/23/hospital-readmission-for-dka-higher-for-black-children-poorer-neighborhoods/
  6. greater risk for developing type 2 diabetes: https://www.diabetesselfmanagement.com/news-research/2021/11/17/living-near-fast-food-restaurants-tied-to-increased-risk-for-type-2/
  7. higher risk for developing type 2 diabetes: https://www.diabetesselfmanagement.com/news-research/2021/03/22/air-pollution-linked-to-type-2-risk-but-exercise-may-help/
  8. if you’re a child: https://www.diabetesselfmanagement.com/blog/air-pollution-diabetes-linked-children-new-study/
  9. sign up for our free newsletters: https://www.diabetesselfmanagement.com/newsletter/
  10. type 2 diabetes: https://www.diabetesselfmanagement.com/diabetes-resources/definitions/type-2-diabetes/
  11. A1C level: https://www.diabetesselfmanagement.com/blog/lowering-a1c-levels-naturally/
  12. HDL: https://www.diabetesselfmanagement.com/blog/hdl-nine-ways-raise-good-cholesterol/
  13. triglycerides: https://www.diabetesselfmanagement.com/diabetes-resources/definitions/triglycerides/
  14. “Six Ways to Save Money on Groceries”: https://www.diabetesselfmanagement.com/healthy-living/nutrition-exercise/covid-19-pandemic-six-ways-to-save-money-on-groceries/
  15. “Resources for Affording Food.”: https://www.diabetesselfmanagement.com/healthy-living/nutrition-exercise/resources-for-affording-food/

Source URL: https://www.diabetesselfmanagement.com/news-research/2022/06/17/food-insecurity-residential-racial-segregation-linked-to-diabetes-outcomes/


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