Food Security & Diabetes
by Jamillah Hoy-Rosas, MPH, RD, CDE
Brooklyn -Stay Well, Enjoy Life (B-SWEL) Medical Case Manager
Working with low income clients with diabetes, food security is often a major concern. Being food insecure is defined as not having enough resources available to fully meet everyday food needs. Almost 15% of all households in the US experience food insecurity (1). Those living in food insecure households are more likely to skip meals when resources are low and overeat when food is available. Some clients must make difficult decisions monthly about whether to buy the healthy nutritious foods recommended to manage their diabetes (whole grains, fruits, vegetables, lean protein and low-fat dairy) or buy cheaper poor quality food options which are full of added fats, sugars and sodium. Clients with diabetes also have many medical needs that strain their monthly budget in addition to their basic need for food. Much of their disposable income is spent on prescriptions, testing supplies and multiple doctor visit co-pays and transportation services to medical appointments. Studies have shown that people diagnosed with diabetes have an additional $13,700 worth of medical expenditures per year, more than double the costs of those without diabetes (2). Even those with good insurance coverage and minimal complications may find their out of pocket costs for managing their diabetes run approximately $350/month or more, which can strain the food budget of any household.
Food insecurity has been shown to decrease successful diabetes self-management. Clients with food insecurity have higher HbA1c values (indicating poor blood sugar control) and find it more difficult to care for their diabetes, fill prescriptions and follow a proper diet. For our clients with food insecurity, we help provide access to safety net programs such as WIC or food stamps that can increase their household’s resources and purchasing power. We also make referrals to local food pantries and congregate meal programs. We encourage clients to plan for the boom/bust nature of their monthly finances by purchasing items in bulk, on sale, when they have more money (the beginning of the month) so that these resources will last the entire month. We emphasize long-lasting non-perishable foods in their meal plans such as whole grain cereals, pastas and rice, dried beans and seeds, nuts, canned vegetables and canned fish (tuna, salmon or sardines) to help stretch their food dollars. To learn more about healthy eating on a lean budget for those with diabetes, try these resources: https://dpg-storage.s3.