Abstract
Diabetes is common in urban settings in Sub-Saharan Africa. Household food insecurity has been suggested to increase the chance of developing diabetes among adults. The relationship between diabetes and food insecurity has not been explored in Angolan urban settings so far. This case–control (1:2) study investigated the association between diabetes and food insecurity among adults attending six healthcare facilities in Luanda (Angola) between April 2019 and September 2019. All subjects with fasting blood glucose (FBG) levels ≥ 126 mg/dl were included as cases. For each case, the next two subjects with FBG levels < 110 mg/dl were included as controls, to warrant the achievement of the set 1:2 ratio. Food insecurity was assessed using the Food Insecurity Experience Scale (FIES). A total of 663 participants (221 cases and 442 controls) were enrolled in the study. Median FIES raw score was 7 (IQR 1–8) in cases and 5 (IQR 2–8) in controls (p = 0.09). The distribution of FIES levels (0–3; 4–6; 7–8) was different between cases and controls (p < 0.0001), with highest FIES scores (7–8) recorded in 53.0% of cases and 38.2% of controls. Our findings revealed an association between diabetes and severe food insecurity among adults attending healthcare facilities in the capital city of Angola.
Highlights
Diabetes is common in urban settings in Sub-Saharan Africa
Food security and food insecurity were calculated according to Food Insecurity Experience Scale (FIES) in 215 cases and 432 controls (Table 2), while the information was incomplete in the other 16 participants
moderate-severe food insecurity (MSFI) was found in 135/215 cases (62.8%) and 276/432 controls (63.9%)
Summary
Diabetes is common in urban settings in Sub-Saharan Africa. Household food insecurity has been suggested to increase the chance of developing diabetes among adults. A recent systematic review in high and middle-income countries supported the hypothesis that household food insecurity may increase the chance of developing diabetes among adults, and suggested the following mechanism: food insecure individuals usually adopt unhealthy eating behaviours such as consuming processed foods which are inexpensive and a ccessible[8]. This can lead to an increased total energy intake, accumulation of visceral fat, and subsequent development of chronic disease like diabetes
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