2310-P: Daily Food Insecurity and Daily Glucose Time in Range in Young Adults and Adults with Youth-Onset Diabetes: Distinguishing Within-Person from Between-Person Associations

Introduction and Objective: Food insecurity (FI) is linked to higher hemoglobin A1c in young adults and adults (YAA) with diabetes. Little is known about the dynamic short-term impact of FI on the glucose time in range (TIR). We assessed the relation between FI on a given day and the same or next day TIR (70-180mg/dL) within individuals with type 1 (T1D) and type 2 diabetes (T2D). Methods: From 2024 to 2025, 143 YAA with youth-onset T1D and 40 with youth-onset T2D (mean age 29.8 and 32.5 years) participated in the ongoing multicenter SEARCH Food Security Cohort Study 2, conducted at three US sites, using ecological momentary assessment. Participants completed three food security questions, adapted from the first three items of the Household Food Security Survey Module, once each evening for 14 days while wearing a continuous glucose monitor. Linear mixed-effects models were employed to assess within- and between-person associations between daily FI (number of FI affirmations, scored 0-3) and daily TIR, adjusting for sociodemographic and clinical variables. Results: The mean daily FI score for participants with T1D and T2D was 0.4 and 0.6, with mean daily TIR of 59.8% and 57.5%, respectively. Within any given participant, a deviation from their mean FI score on a given day did not correlate with the TIR on the same day or the following day in YAA with T1D (β=0.74, p=0.35; β=-0.04, p=0.96) and T2D (β=-1.80, p=0. 22; β=-2.10, p=0.21). Between participants, a one-unit higher mean FI score corresponded to 6 percentage points lower daily TIR in T1D (β=-6.29, p=0.009) and -21 percentage points in T2D (β=-21.22, p=0.008). Conclusion: YAA with diabetes who exhibit more FI have lower daily TIR than their counterparts; however, the TIR does not differ across days with reported FI vs. security within a participant. These findings indicate that the presence of FI correlates with lower daily TIR, even during intermittent days of food security, and highlight the importance of preventing any FI experiences. Disclosure E.F. Julceus: None. J.A. Mendoza: None. F. Malik: None. T. Bekelman: None. E.A. Frongillo: None. E. Cobry: None. K. Flory: None. C. Pihoker: None. L. Knight: None. J. Yang: None. R.E. Davis: None. D. Dabelea: None. A.D. Liese: None. Funding National Institutes of Health R01DK117461