Introduction and Objective: Older adults with Type 2 diabetes (T2D) have elevated risk of hypoglycemia, leading to falls, cognitive decline, and reduced quality of life. Hypoglycemia-related distress can drive maladaptive insulin adjustments, dietary changes, and suboptimal glycemic control. Food insecurity may worsen this distress by limiting access to consistent meals. We examined associations between two aspects of food insecurity and hypoglycemia distress. Methods: SAGE (NCT06296485) is an RCT testing whether CGM reduces hypoglycemia in older high-risk adults with insulin-treated T2D. We analyzed baseline surveys from 218 participants, including the validated Hypoglycemia Distress Scale and demographic/socioeconomic items. Independent predictors of hypoglycemia distress were identified using multivariate logistic models. Results: Participants averaged 79 (+/- 3.8) years old, with 53% identifying as female. In the past year, 79% (172/218) experienced symptoms of hypoglycemia. Participants who experienced food insecurity reported higher hypoglycemia distress than those who did not. This includes both financial (“food running out”; 70% vs. 45%; p=0.036) and physical (“difficulty buying/preparing”; 74% vs. 45%; p=0.018) food insecurity. In logistic models adjusting for demographics, both financial (aOR 4.58, 95% CI 1.43, 18.00) and physical (aOR 3.51, 95% CI 1.19, 12.10) food insecurity were associated with risk of hypoglycemia distress. Patients who reported both forms of food insecurity had 7 times greater risk (aOR 7.38, 95% CI 1.67, 55.70) of hypoglycemia distress than those who did not experience either form of food insecurity. Conclusion: In older patients at high risk for hypoglycemia, self-reported food insecurity due to financial and physical reasons were associated with significantly greater risk of hypoglycemia distress. This underscores the need to screen for and address food insecurity, including physical food insecurity which is not included in standard screening tools. Disclosure M. Tran: None. E.M. Fernandez: None. O. Jamal: None. S.C. Gonzalez: None. A.J. Karter: Research Support; Current; Dexcom, Inc. L.K. Gilliam: None. M. Chen: None. R.W. Grant: None. Funding National Institute of Diabetes and Digestive and Kidney Diseases (R01DK134446)
Tran et al. (Fri,) studied this question.