Adherence
Food insecurity in diabetic patients significantly increases the risk of hypoglycemia and poor glycemic control (higher A1c) due to the trade-off between purchasing food and purchasing diabetes medications/supplies.
If you have diabetes and struggle to afford food, do not simply 'try harder' to follow your diet. The cost of food often forces you to skip medications, causing dangerous blood sugar swings. Talk to your doctor about switching to medications with a lower risk of hypoglycemia (like Metformin or DPP-4 inhibitors) or adjusting your insulin regimen to be more flexible, so you don't have to choose between eating and staying safe.
Ultimately, the choice between food and medication predisposes individuals either to hypoglycemia (if medications are taken instead of food) or hyperglycemia (if food is eaten instead of medications taken)... Food-insecure diabetics have marginally higher A1c levels than food-secure diabetics... and are at increased risk for poorer glycemic control (A1c levels higher than 7%)
Why this rating
Based on multiple observational studies (NHANES, longitudinal surveys) cited in the review, though causality is complex.
Source
The Intersection between Food Insecurity and Diabetes: A Review
Enza Gucciardi et al. · Current Nutrition Reports · 2014
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