# Diabetes Self-Management Education and Support for People with Type 2 Diabetes Experiencing Food Insecurity: A Mixed Methods Study

> **NIH NIH F32** · MASSACHUSETTS GENERAL HOSPITAL · 2024 · $83,932

## Abstract

PROJECT SUMMARY/ABSTRACT
Food insecurity disproportionately affects people with diabetes mellitus and is associated with suboptimal
diabetes self-management behaviors and poor diabetes outcomes including hypoglycemia, poor glycemic
control, and increased acute healthcare utilization. Standardized diabetes self-management education and
support (DSMES) services designed to improve health behaviors of people with diabetes are associated with
improved diabetes outcomes but have rarely been studied in people experiencing food insecurity, who face
unique challenges in diabetes self-management. The proposed research aims to adapt and develop a DSMES
intervention for people with food insecurity. The candidate will use formative mixed methods research to
determine the nutritional, behavioral, and psychological barriers to diabetes self-management for people with
food insecurity and type 2 diabetes (T2D) to inform the development of the intervention, which will focus on
strategies to improve nutrition and mitigate medication-related barriers relevant to this population. Results of
this study will contribute to the limited body of research centered on DSMES services for people with health-
related social needs and provide preliminary data for a future career development award to test whether the
adapted intervention improves the effectiveness of DSMES for people with food insecurity. The three-part aim
will (a) use quantitative methods to identify demographic, psychosocial, and behavioral factors associated with
low dietary quality in a cohort of low-income patients with T2D (N=161); (b) use qualitative methods to
interview patients (n=25) and providers (n=5) to explore key barriers in this population; and (c) adapt a DSMES
intervention to the specific needs of this population using findings from (a) and (b). The candidate will complete
the proposed work under the mentorship of Drs. Anne Thorndike, an expert in behavioral interventions for
cardiometabolic disease prevention and management, and Deborah Wexler, an expert in T2D and intervention
design. In addition to their direct mentorship, the candidate will pursue formal coursework in qualitative
research methods and design and evaluation of health interventions and will participate in regular collaborative
research meetings related to diabetes, qualitative research, and health behavior interventions. The Divisions of
Endocrinology, Diabetes, and Metabolism and General Internal Medicine at Massachusetts General Hospital
will provide an unparalleled environment for trainee learning. This application represents a comprehensive plan
to develop an intervention to improve equity in diabetes management for people experiencing health-related
social needs, and to prepare the candidate to apply for a career development award with the ultimate goal of
becoming an independent clinical investigator.

## Key facts

- **NIH application ID:** 10995587
- **Project number:** 1F32DK141094-01
- **Recipient organization:** MASSACHUSETTS GENERAL HOSPITAL
- **Principal Investigator:** Kristine Gu
- **Activity code:** F32 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $83,932
- **Award type:** 1
- **Project period:** 2024-07-01 → 2025-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10995587

## Citation

> US National Institutes of Health, RePORTER application 10995587, Diabetes Self-Management Education and Support for People with Type 2 Diabetes Experiencing Food Insecurity: A Mixed Methods Study (1F32DK141094-01). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10995587. Licensed CC0.

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