Dr. Angela Liese, professor of epidemiology and biostatistics at the University of South Carolina’s Arnold School of Public Health, will serve as the principal investigator on a more than $3.3 million, five-year grant from the National Institute of Diabetes and Digestive and Kidney Diseases, together with her long-term collaborator, Dr. Jason Mendoza of Seattle Children’s’ Research Institute. With a team of 15 collaborators from eight different institutions, the project will examine the impact of disparities in food security on glycemic control and health care utilization among youth and young adults with diabetes in three areas of the United States, including South Carolina, Seattle, Washington and surrounding counties, and Colorado.
This research will leverage data from the ongoing SEARCH for Diabetes in Youth Study (2015-2020) combined with new data to conduct a food insecurity-focused longitudinal study. The multi-site study will be the first to characterize the unique household food insecurity challenges and consequences experienced by youth and young adults with diabetes in the U.S. It will also be the first to examine household food insecurity as a mechanism for disparities in adverse outcomes among minorities within this population.
“Food insecurity is at near-record-high levels in the U.S.,” says Dr. Liese. “In 2015, for example, one in eight households was food insecure, with one in six households with children affected.”
Meanwhile, researchers have documented increases in both Type 1 and Type 2 diabetes. Between 2001 and 2009, the prevalence of Type 1 and Type 2 diabetes increased by 21 percent and 31 percent, respectively. The incidence of Type 1 increased to a much greater degree among Hispanics and non-Hispanic blacks compared to non-Hispanic whites. There were also disparities in Type 2 diabetes in these groups.
Among those who have diabetes, 55.6 percent of youth and young adults with Type 1 diabetes (45 percent with Type 2) do not achieve optimal glycemic control — the overarching goal of diabetes management, which is key to reducing the risk of morbidity and preventing premature mortality. Again, minorities are further disadvantaged, with 65 percent of non-Hispanic black and 61 percent of Hispanic youth and young adults with Type 1 diabetes not achieving optimal glycemic control compared to 29 percent of non-Hispanic whites (for Type 2 diabetes, these numbers are 41 and 49 percent vs 19 percent, respectively).
“These trends suggest that an increasing number of youth and young adults, particularly minorities and many with food insecurity, will be burdened with diabetes,” says Dr. Liese. “Our preliminary data show that food insecurity affects 19 percent of those with Type 1 and 38 percent of those with Type 2 diabetes.”