Prevalance and associations of food insecurity in children with diabetes mellitus.
OBJECTIVE
To examine the prevalence of food insecurity in households with a child with insulin-requiring diabetes mellitus (DM), investigate whether food insecurity is associated with poorer DM control, and describe the household characteristics and coping strategies of food-insecure families with a child with DM.


METHODS
Telephone interviews were conducted with consecutive consenting families over a 16-month period. Food insecurity was assessed through a validated questionnaire; additional questions elicited demographic information and DM management strategies. Charts were reviewed for hemoglobin A1c (HbA1c). Univariate and logistic regression analyses were performed.


RESULTS
A total of 183 families were interviewed. Food insecurity was present in 21.9% (95% confidence interval, 15.87%-27.85%), significantly higher than the overall prevalences in Nova Scotia (14.6%) and Canada (9.2%). Food insecurity was associated with higher HbA1c level; however, in multivariate analysis, only child's age and parents' education were independent predictors of HbA1c. Children from food-insecure families had higher rates of hospitalization, for which food security status was the only independent predictor. Common characteristics and coping strategies of food-insecure families were identified.


CONCLUSIONS
Food insecurity was more common in families with a child with DM, and the presence of food insecurity was predictive of the child's hospitalization. Risk factors identified in this study should be used to screen for this problem in families with a child with DM.
Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada.
Stacey
S
Marjerrison
Elizabeth A
EA
Cummings
N Theresa
NT
Glanville
Sara F L
SF
Kirk
Mary
M
Ledwell
D000223:Adaptation, Psychological; D000293:Adolescent; D015992:Body Mass Index; D002648:Child; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000191:economics / Q000453:epidemiology* / Q000628:therapy*; D004032:Diet; D019468:Disease Management; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D015438:Health Behavior; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D006815:Hunger; D008297:Male; D009674:Nova Scotia / Q000453:epidemiology; D011203:Poverty; D011632:Public Assistance / Q000706:statistics & numerical data
D006442:Glycated Hemoglobin