Research studies demonstrate that food insecurity is associated with double the risk of developing diabetes.
Educating doctors in the treatment of patients with diabetes mellitus always includes the importance of lifestyle changes. In my medical education, I was taught that healthful nutrition is both important for diabetes prevention as well as in controlling blood sugar levels. Referral to a nutrition specialist was and still is mandatory.
What I was not taught is that a significant number of diabetic patients are unable to afford the recommended foods. Logically, public policy should be directed at helping to provide proper nutrition as good treatment for both diabetes prevention and improved blood-sugar control. Sadly, recent attacks on the SNAP program (food stamps) will have the opposite effect. Reducing food availability will result in sicker patients and cost society a lot more money.
Many people face what is termed food insecurity, meaning limited access to good nutrition or skipping meals. Inability to purchase healthful food leads to procurement of low cost, high calorie, high carbohydrate foods, and this has a profoundly negative effect on patients with diabetes.
Research studies demonstrate that food insecurity is associated with double the risk of developing diabetes. Patients with food insecurity experience twice the rate of poor blood-sugar control. Some research papers report a 40 percent chance of patients either buying food and no medicine or reducing the recommended medicine dose to provide food for themselves and their family. A nutritionist can prescribe a healthy diet, but what good will that do if it is unaffordable? Can providing healthful food to a patient with diabetes make a difference in their blood-sugar control?
Food Lifeline, a nonprofit organization in Western Washington dedicated to collecting and distributing food, initiated an ingenious project to find out. The Lifeline agreed to provide free healthful nutrition to a Sea Mar Community Health Center whose patient population includes a large number of diabetics with food insecurity (87 percent of those screened). Volunteers were enrolled and allowed to secure food for themselves and their family. After only three months, more than half the patients improved average blood-sugar control and achieved levels recommended by experts. A quarter improved to the point they required less or even no medication. The overall response was equal to that expected from medications but without possible side effects and at a much lower cost.
Providing nutritious food to a vulnerable diabetic population therefore has more than a humanitarian value. More normal blood sugars have been shown to lead to better health, less need for hospital services and fewer diabetic complications. An added benefit is that families of these patients also eat better, perhaps preventing the next generation from becoming diabetic.
A government policy that threatens access to healthful food is clearly penny wise and pound-foolish. What I have learned in treating and preventing diabetes, a disease that is exploding in frequency, is that there is a desperate need to increase food security. Our society should consider healthful food a potent, safe and cost-effective medication, worthy of more support.