Food insecurity is a major public health concern in the United States affecting 15 million households according to data in 2017 from the US Department of Agriculture. Food insecurity, or the inability to consistently obtain nutritious food, disproportionately affects socioeconomically disadvantaged households, as well as those with chronic diseases including diabetes mellitus (DM). This review article explores the literature over the past 10 years pertaining to the complex relationship between food insecurity, social determinants of health, and chronic disease with an emphasis on diabetes and glycemic control. Those with diabetes and food insecurity together have been shown to have worse glycemic control compared to those who are food secure, but it remains unclear exactly how food insecurity affects glycemic control. Prior interventional studies have targeted aspects of food insecurity in patients with diabetes but have reported variable outcomes with respect to improvement in glycemic control despite effectively reducing rates of food insecurity. Additionally, few data exist regarding long‐term outcomes and diabetes‐related complications in this population. It is likely that many factors at both the community and individual levels impact glycemic control outcomes in the setting of food insecurity. Further studies are needed to better understand these factors and to create multifaceted targets for future interventional studies aimed at improving glycemic control in this population.

中文翻译：

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糖尿病患者食品安全性的新兴趋势和临床影响。

根据美国农业部2017年的数据，粮食不安全是美国主要的公共卫生问题，影响1500万个家庭。粮食不安全或无法持续获得营养食品，对社会经济上处于不利地位的家庭以及患有包括糖尿病（DM）在内的慢性疾病的家庭造成了不成比例的影响。这篇综述文章探讨了过去十年中与粮食不安全，健康的社会决定因素和慢性病之间的复杂关系有关的文献，重点是糖尿病和血糖控制。与那些有食品安全的人相比，患有糖尿病和食品不安全的人的血糖控制能力较差，但尚不清楚确切的食品不安全感如何影响血糖控制。先前的干预性研究针对的是糖尿病患者食物不安全的方面，但是尽管有效降低了食物不安全的发生率，但报告了在改善血糖控制方面的不同结果。此外，在该人群中，关于长期结局和糖尿病相关并发症的数据很少。在粮食不安全状况下，社区和个人层面的许多因素都可能影响血糖控制的结果。需要进行进一步的研究以更好地理解这些因素，并为将来的旨在改善该人群血糖控制的干预研究创建多方面的目标。