title: Household food insecurity and medication "scrimping" among US adults with diabetes.
abstract: OBJECTIVE
  Our research examined the prevalence of food insecurity among adults with self-reported diabetes and whether food insecurity was associated with cutting back ("scrimping") on prescribed medications because of financial constraints.
  
  
  METHODS
  We conducted a cross-sectional analysis of data from the 2011 National Health Interview Survey (NHIS). Adults completing this survey were considered to have diabetes if they reported current use of insulin or "diabetic pills" (n=3,242). Food insecurity was determined with a 10-item scale; respondents were categorized as food secure (FS), marginally food secure (MFS) or food insecure (FI).
  
  
  RESULTS
  Approximately one in six adults in NHIS with diabetes reported food insecurity (17.0%), and an additional 8.8% were marginally FS. An individual was considered to be scrimping on medications if he/she gave a "yes" response to at least one of four questions pertaining to reduced, delayed or avoided medication use. Overall, 18.9% of respondents with diabetes reported one or more type of medication scrimping: 11.7% of FS individuals, 27.7% of MFS individuals and 45.6% of FI individuals. In adjusted analyses, marginal food security and food insecurity remained strongly associated with scrimping.
  
  
  CONCLUSIONS
  One-quarter of adults with diabetes may have difficulty obtaining foods appropriate for a diabetic diet; a substantial number of these individuals also fail to obtain or take medications. Practitioners may miss either problem unless targeted questions are included in clinical encounters. Clinicians should consider referring FI and MFS diabetic patients to community food resources.
authors.affiliation: South Carolina Department of Health and Environmental Control, United States. Electronic address: chadwick159@hotmail.com.
authors.forename: Chadwick K
authors.initials: CK
authors.lastname: Knight
authors.affiliation: Department of Health Services Policy and Management, Arnold School of Public Health, 915 Greene Street, Room 355, University of South Carolina, Columbia, SC 29208, United States.
authors.forename: Janice C
authors.initials: JC
authors.lastname: Probst
authors.affiliation: Department of Epidemiology and Biostatistics, Arnold School of Public Health, 915 Greene Street, Room 461, University of South Carolina, Columbia, SC 29208, United States.
authors.forename: Angela D
authors.initials: AD
authors.lastname: Liese
authors.affiliation: Cancer Prevention and Control Program, Arnold School of Public Health, 915 Greene Street, Room 249, University of South Carolina, Columbia, SC 29208, United States.
authors.forename: Erica
authors.initials: E
authors.lastname: Sercye
authors.affiliation: Department of Health Promotion, Education and Behavior, Arnold School of Public Health, 915 Greene Street, Room 435B, University of South Carolina, Columbia, SC 29208, United States.
authors.forename: Sonya J
authors.initials: SJ
authors.lastname: Jones
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000178:diet therapy / Q000188:drug therapy / Q000191:economics*; D005260:Female; D005523:Food Supply / Q000191:economics*; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D011203:Poverty / Q000191:economics; D012959:Socioeconomic Factors; D014481:United States; D055815:Young Adult; D016903:Drug Monitoring
keywords: Diabetes; Food insecurity; Medication restriction