Household Food Insecurity and Fear of Hypoglycemia in Adolescents and Young Adults with Diabetes and Parents of Youth with Diabetes
Objective: To evaluate the relation between household food insecurity (HFI) and fear of hypoglycemia among young adults with type 1 and type 2 diabetes, adolescents with type 1 diabetes, and their parents.
Research Design and Methods: We analyzed cross-sectional data of 1,676 young adults with youth-onset diabetes (84% type 1, 16% type 2) and 568 adolescents (<18 years; mean age 15.1 years) with type 1 from the SEARCH for Diabetes in Youth Study. Adult participants and parents of adolescent participants completed the US Household Food Security Survey. Adults, adolescents, and parents of adolescents completed the Hypoglycemia Fear Survey, where answers range from 1-4. The outcomes were the mean score for fear of hypoglycemia and the behavior and worry subscale scores. Linear regression models identified associations between HFI and fear of hypoglycemia scores.
Results: Adults with type 1 diabetes experiencing HFI had higher fear of hypoglycemia scores (+0.22 units for behavior, +0.55 units for worry, +0.40 units for total, all p<0.0001) than those without HFI. No differences by HFI status were found for adolescents with type 1 diabetes. Parents of adolescents reporting HFI had a 0.18 unit higher worry score than those not reporting HFI (p<0.05). Adults with type 2 diabetes experiencing HFI had higher fear of hypoglycemia scores (+0.19 units for behavior, +0.35 units for worry, +0.28 units for total; all p<0.05) than those in food secure households.
Conclusions: Screening for HFI and fear of hypoglycemia among people with diabetes can help providers tailor diabetes education for those who have HFI and therefore fear hypoglycemia.
