Prevalence and underdiagnosis of diabetes mellitus in a food insecure population

Food insecurity is a public health issue and a major risk factor for overall worse health outcomes including hypertension, diabetes, coronary heart disease, congestive heart failure, stroke, chronic kidney disease and obesity. Food-insecure patients are more likely to have both diagnosed and undiagnosed prediabetes and diabetes. This study examines the prevalence and self-awareness of diabetes and prediabetes in an at-risk, food-insecure population. The Cardiometabolic Health Initiative (CHI) is a community service organization that provides comprehensive cardiometabolic screenings at food pantries in West Chicago. Between August 2023 and December 2024, 191 patients were screened using point-of-care A1c tests. The average A1c of the population was 6.04%. Ninety-six patients had a normal A1c (< 5.7%), 66 had a prediabetic A1c (5.7-6.4) and 29 had a diabetic A1c (> 6.4). Forty-two patients self-reported a history of DM. The average A1c for the self-reported DM group was 7.58% and the average A1c for the non-reported group was 5.60%. Among the self-reported DM group, 24 patients had controlled DM (A1c < 7%) and 18 had uncontrolled DM (A1c > 7%). Among the non-reported group, 56 had a prediabetic A1c and 3 had a diabetic A1c. The presented findings suggest a high prevalence of diabetes and prediabetes within a food-insecure population in West Chicago. Further, this study suggests that many diabetic patients struggle to control their A1c levels. Our findings reflect many barriers presented to food insecure patients that can hinder diabetes diagnosis, education, and management.