1396-P: Association of Food Security Status, Clinical Characteristics, and Glycemic Control in Patients on Dialysis

Introduction and Objective: Food insecurity (FI) is associated with poorer glycemic control in people with diabetes (DM). In adults with CKD, FI is associated with a higher risk of progression to ESRD. This study analyzed the association of FI with clinical characteristics and glycemic trends in patients on dialysis. Methods: In a prospective cohort study, 409 participants on dialysis wore a Dexcom G6 Pro continuous glucose monitor for 10 days and completed FI screening with a validated two-item tool. We examined the associations of FI and measures of glycemic control (including mean blood glucose, time in range, coefficient of variation) using multivariable linear regression adjusted for age, sex, dialysis mode, and DM status. We used a chi-square test to examine associations of FI and clinical characteristics. Results: Overall, 85 (21%) participants faced FI, including 54 with DM and 31 without DM. Food security status was not significantly associated with glycemic control in participants with DM on dialysis. In participants without DM on dialysis, there was a modest difference in mean time in range (74% for food secure, 72% for food insecure, adjusted difference -8, 95% CI -15,-1) and mean coefficient of variation (19% for food secure, 20% for food insecure, adjusted difference 2, 95% CI 0,3). Participants with FI were more likely to identify as Hispanic, prefer speaking a non-English language, live alone, have completed high school education or less, be unemployed, have an income of <$20K, and have increased diabetes distress. FI was not associated with age, sex, race, BMI, dialysis mode, or DM status. Conclusion: Unlike the broader diabetes population, FI was not associated with glycemic differences in participants with DM on dialysis in this cohort. History of poor glycemic control in this population may blunt the measured effect of FI. Further study is needed to understand factors contributing to the observed discrepancy in the impact of FI on glycemic control. The association of FI and diabetes distress highlights the quality-of-life implications of FI. Disclosure A. Vasudevan: None. I. de Boer: Consultant; Current; Boehringer Ingelheim International GmbH, Novo Nordisk, GlaxoSmithKline plc., Lilly. Consultant; Ended; Dexcom, Inc. Research Support; Current; Novo Nordisk, Dexcom, Inc. Consultant; Ended; AstraZeneca. Consultant; Current; Roche Diabetes Care. Consultant; Ended; Lexicon Pharmaceuticals, Inc. Y. Hall: None. S. Hingorani: None. I. Hirsch: Research Support; Current; MannKind Corporation, Sequel Tech. Consultant; Current; Abbott Diabetes, Roche Diabetes Care, Hagar. L. Zelnick: None. S. Trikudanathan: Research Support; Current; Zucara Therapeutics, vTv Therapeutics, Rezolute. Funding National Institute of Diabetes and Digestive and Kidney Diseases (R01DK126373)