Association between Food Insecurity and Inability to Obtain Provider-Recommended Medications, Multidisciplinary Services, and Technology in Youth and Young Adults with Diabetes: A Cross-Sectional Study

Abstract

We assessed if food insecurity (FI) is associated with not obtaining recommended diabetes medications, technology, and multidisciplinary services, and explored the most common reasons for not obtaining recommended treatments in youth and young adults (YYA) with diabetes. In this cross-sectional study, among 911 YYA with type 1 diabetes (T1D) and 144 with type 2 diabetes (T2D) from the SEARCH Food Security Cohort Study Follow-up 1 (2018-2021), FI (≥3 items affirmed from the 18-item Household Food Security Survey module) and inability to obtain recommended treatments were self-reported. Almost 30% of YYA with T1D and FI and 20% of YYA with T2D and FI did not obtain one or more recommended treatments. Participants with T1D who reported FI had higher odds of not obtaining insulin (OR 3.2, 95% CI 1.2-8.4), mental health counseling (OR 3.3, 95% CI 1.3-8.2), diabetes education (OR 3.6, 95% CI 1.4-9.3), an insulin pump (OR 2.2, 95% CI 1.2- 4.4), and a continuous glucose monitor (CGM) (OR 2.5, 95% CI 1.5-4.4) compared to those who reported food security (FS). Among participants with T2D, FI was related to not obtaining dietician services (OR 8.1, 95% CI 1.2-53.8). Participants with T1D and FI reported more financial reasons for not obtaining a CGM compared to FS participants. YYA with diabetes and FI face constraints in obtaining medications, diabetes technology, and multidisciplinary services, largely due to financial and structural reasons. New strategies are needed to bridge the gap between medical care required versus obtained by YYA with diabetes.