title: Prevalence of food insecurity in patients with diabetes in western Kenya.
abstract: OBJECTIVE
  To determine the characteristics of patients with diabetes who reported food insecurity at three diabetes clinics in western Kenya.
  
  
  METHODS
  This study includes routinely collected demographic data at the first presentation of patients with diabetes at clinics in western Kenya from 1 January 2006 to 24 September 2011. A validated questionnaire was used to assess food insecurity with descriptive and comparative statistics being used to analyse the food-secure and food-insecure populations.
  
  
  RESULTS
  The number of patients presenting to these clinics who were food-secure and those who were food-insecure was 1179 (68.0%) and 554 (32.0%), respectively. Comparative analysis shows a statistically significant difference in weight, BMI, the presence of a caretaker, and use of insulin between the two groups. These variables were lower in the food-insecure group. The overall assessment of the clinic population revealed an abnormally high mean HbA1c concentration of 81 mmol/mol (9.6%).
  
  
  CONCLUSIONS
  Despite the widely recognized contribution of caloric over-nutrition to the development of diabetes, this study highlights the high prevalence of food insecurity amongst patients with diabetes in rural, resource-constrained settings. Other factors, such as the lower prevalence of obesity, poor glucose control, challenges in the use of insulin because of the risk of hypoglycaemia, and varying subtypes of diabetes in this population, point to the need for additional research in understanding the aetiology, pathophysiology and optimum management of this condition, as well as understanding the effects of enhancing food security.
authors.affiliation: Purdue University College of Pharmacy, West Lafayette, IN, USA.
authors.forename: S
authors.initials: S
authors.lastname: Cheng
authors.forename: J
authors.initials: J
authors.lastname: Kamano
authors.forename: N K
authors.initials: NK
authors.lastname: Kirui
authors.forename: E
authors.initials: E
authors.lastname: Manuthu
authors.forename: V
authors.initials: V
authors.lastname: Buckwalter
authors.forename: K
authors.initials: K
authors.lastname: Ouma
authors.forename: S D
authors.initials: SD
authors.lastname: Pastakia
mesh_terms: D015992:Body Mass Index; D003131:Combined Modality Therapy; D003151:Community Health Centers; D003920:Diabetes Mellitus / Q000178:diet therapy / Q000188:drug therapy / Q000191:economics / Q000209:etiology*; D004032:Diet / Q000009:adverse effects* / Q000191:economics / Q000208:ethnology / Q000523:psychology; D003927:Diet, Diabetic / Q000009:adverse effects / Q000191:economics / Q000208:ethnology / Q000523:psychology; D005191:Family Characteristics / Q000208:ethnology; D005260:Female; D005523:Food Supply / Q000191:economics; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D006943:Hyperglycemia / Q000453:epidemiology / Q000517:prevention & control; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use; D007328:Insulin / Q000008:administration & dosage / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use; D007630:Kenya / Q000453:epidemiology; D008297:Male; D044342:Malnutrition / Q000191:economics / Q000208:ethnology / Q000209:etiology / Q000503:physiopathology*; D008875:Middle Aged; D044343:Overnutrition / Q000191:economics / Q000208:ethnology / Q000209:etiology / Q000503:physiopathology*; D011204:Poverty Areas; D012423:Rural Health / Q000191:economics / Q000208:ethnology; D012959:Socioeconomic Factors
chemical_list: D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; C517652:hemoglobin A1c protein, human