# Impact of Disparities in Food Security on Glycemic Control and Health Care Utilization Among Youth and Young Adults with Diabetes

> **NIH NIH R01** · UNIVERSITY OF SOUTH CAROLINA AT COLUMBIA · 2022 · $637,538

## Abstract

PROJECT SUMMARY / ABSTRACT
Despite recent advances in therapy, far too many youth and young adults (YYAs) with type 1 diabetes (T1D)
and type 2 diabetes (T2D), particularly those of minority race/ethnicity, do not achieve optimal glycemic control
thus placing them at increased risk of acute and chronic complications. Among the social determinants of
health, household food insecurity (HFI) may be a key barrier to achieving glycemic control and may lead to
increased health care utilization and costs, but virtually all of the limited research was cross-sectional and
conducted in older adults with T2D. Moreover, racial/ethnic minorities are disproportionately affected by HFI,
which may underlie similar disparities in diabetes outcomes. Our preliminary work suggests that HFI is a
common phenomenon in YYAs with diabetes, affecting 19% of YYAs with T1D and 38% of those with T2D.
These rates significantly exceed the 2015 national estimate of 12.7%. We propose a longitudinal study, the
SEARCH Food Security (SFS) cohort study, which is designed as an ancillary study to the ongoing CDC/DDT-
and NIH/NIDDK-funded SEARCH for Diabetes in Youth 4 study, a racially/ethnically diverse study of diabetes
diagnosed in youth. The aims of the SFS study are to: (1) Initiate a food insecurity cohort study of 1,187 YYAs
aged 15-35 years (53% minority) with T1D and T2D by adding two data collection time points to the ongoing
SEARCH 4 study; (2) Prospectively evaluate the influence of HFI on changes in glycemic control in YYAs with
T1D and T2D; (3) Quantify the mediating role of nutritional, mental health, and behavioral pathways through
which food insecurity may affect changes in glycemic control in YYAs with T1D and T2D; and (4) Prospectively
evaluate the influence of HFI on changes in health care utilization and medical and non-medical health care
costs in YYAs with T1D and T2D. Using the SFS data in tandem with extensive data collected by SEARCH will
be highly efficient for addressing these aims. The proposed study will be the first cohort study to examine the
impact of food insecurity on glycemic control, health care utilization, and costs among a diverse population of
US YYAs with T1D and T2D. Our transdisciplinary team is led by Drs. Liese and Mendoza, recognized experts
in diabetes, epidemiology, pediatric medicine, disparities, and food insecurity research, and is supported by a
team comprising expertise in pediatric endocrinology, psychology, health behaviors, health economics,
biostatistics, and causal inference modeling. The study has the potential to alter diabetes policy and clinical
practice by establishing the need for more in-depth assessments of food insecurity among YYAs with diabetes,
re-assessment of diabetes management and nutrition recommendations for food-insecure patients, and
integration of food assistance resources into routine care for persons with diabetes. It will also inform the
tailoring of interventions to address food insecurity, especially...

## Key facts

- **NIH application ID:** 10379359
- **Project number:** 5R01DK117461-05
- **Recipient organization:** UNIVERSITY OF SOUTH CAROLINA AT COLUMBIA
- **Principal Investigator:** ANGELA D LIESE
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $637,538
- **Award type:** 5
- **Project period:** 2018-04-01 → 2023-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10379359

## Citation

> US National Institutes of Health, RePORTER application 10379359, Impact of Disparities in Food Security on Glycemic Control and Health Care Utilization Among Youth and Young Adults with Diabetes (5R01DK117461-05). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10379359. Licensed CC0.

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