Food Insecurity Screening Among Families of Children With Diabetes

Abstract

ood insecurity (FI) is consistently more prevalent among households of people living with diabetes than families or adults without chronic disease (1-4), and it is particularly high among households of children with diabetes (5). With healthy eating at the cornerstone of all diabetes care strategies for both adults and children, FI can have a significant negative impact on diabetes management. Current evidence indicates that people with diabetes and FI are at increased risk for poor glycemic control (A1C >7%), hypoglycemia (6), hyperglycemia (7), and chronic diseases related to diabetes complications (8). In children, poor glycemic control can have severe consequences such as hypoglycemia and ketoacidosis, leading to hospital admissions (5), as well as various chronic complications later in life (9). The importance of routine screening for FI in the diabetes population is

Intersection of food insecurity and moral experiences of those involved in paediatric healthcare: A scoping review of child, caregiver and healthcare provider perspectives

“…Concerns were expressed about being judged, shamed, or embarrassed (Barnidge et al, 2020; Cullen et al, 2020; Knowles et al, 2018; Vitale et al, 2019). HCPs recognised these caregiver concerns and acknowledged the potential for stigma (Knowles et al, 2018; Palakshappa et al, 2017b): “…the sense I get is that parents feel that one of their responsibilities is to provide for their children, that someone may judge them as failing to be their responsibility” (Okafor et al, 2020: p. 6).…”

“…Systems barriers were also cited by HCPs as factors that signposted whether FI was core business for health services. HCPs experienced lack of time as a significant constraint for adequately dealing with FI disclosure (Knowles et al, 2018; Okafor et al, 2020; Palakshappa et al, 2017b; Vitale et al, 2019). HCPs also felt a need for access to local resources so they could feel ‘empowered’ to help families (Palakshappa et al, 2017b).…”

“…She tries to empower you’ (Barnidge et al, 2020: p.106). The key importance of HCP-caregiver relationships in allowing for frank discussion and disclosure was also perceived as important by HCPs: ‘…because of this close relationship we have, they would tell us’ (Vitale et al, 2019: p.344).…”

“…Moreover, caregivers and HCPs described normalising FI as a way of conveying that asking about FI was not about getting ‘found out’ but about getting help (Barnidge et al, 2020; Cullen et al, 2020; Palakshappa et al, 2017b; Vitale et al, 2019):“ …and I think when we talk about it a little more, and about the prevalence of food insecurity then families seem more okay with it. I think they’re much more receptive to it…” (Palakshappa et al, 2017b: p.5).…”

“…It was very uncomfortable. It would have been different, however, if she [her daughter] wasn’t there” (Vitale et al, 2019: p.344)…”