Evidence map›Paper›PMID 40681337›Full record

ArticleJournal of epidemiology and community health2025

Heterogeneity in associations between food insecurity and diabetes outcomes.

Seth A Berkowitz, Mufeng Gao, Aileen Ochoa, Marlena L Kuhn, Jenine Dankovchik, Jenna M Donovan, Myklynn LaPoint, Sanjay Basu, Michael G Hudgens, Rachel Gold

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In one paragraph

Article in Journal of epidemiology and community health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Seth A BerkowitzDivision of General Medicine and Clinical Epidemiology, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA seth_berkowitz@med.unc.edu.ORCID 0000-0003-1030-4297
Mufeng GaoDepartment of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Aileen OchoaDepartment of Research, OCHIN, Portland, Oregon, USA.
Marlena L KuhnDepartment of Social Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Jenine DankovchikDepartment of Research, OCHIN, Portland, Oregon, USA.
Jenna M DonovanDepartment of Research, OCHIN, Portland, Oregon, USA.
Myklynn LaPointCenter for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Sanjay BasuWaymark Care, San Francisco, California, USA.
Michael G HudgensDepartment of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Rachel GoldDepartment of Research, OCHIN, Portland, Oregon, USA.

Funding

Translational Research Core - Health Engagement & Action Translational (HEAT)P30DK092924 · NIDDK · KAISER FOUNDATION RESEARCH INSTITUTE · PI Alyce Sophia Adams, HILARY Kessler SELIGMAN · 2011 to 2026
$9.2M
Testing combinations of population interventions to encourage healthy eatingR01DK116852 · NIDDK · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI SCHILLINGER, DEAN · 2018 to 2022
$3.7M
SOCRATES: SOCial Risk and diAbetes ouTcomEs StudyR01DK125406 · NIDDK · UNIV OF NORTH CAROLINA CHAPEL HILL · PI BERKOWITZ, SETH A · 2021 to 2025
$3.0M
NCCDPHP CDC HHS U18 DP006526NIDDK NIH HHS P30 DK092924NIDDK NIH HHS R01 DK116852NIDDK NIH HHS R01 DK125406
6 · The paper itself

Abstract

backgroundFood insecurity is associated with worse diabetes outcomes, but how that association may vary across individuals is unclear. We sought to better understand possible heterogeneity in the association between food insecurity and diabetes outcomes.

methodsLongitudinal cohort study of adults with type 2 diabetes assessed for food insecurity in community-based health centres. Diabetes outcomes were haemoglobin A1c (HbA1c), systolic and diastolic blood pressure, and low-density lipoprotein cholesterol (LDL), 12 months after food insecurity assessment. We used three machine learning methods (generalised random forest (GRF), X-Learner and Doubly Robust Learner) to assess outcome heterogeneity across the following variables: age, sex, race and ethnicity, health insurance, income, comorbidity, baseline outcome and social vulnerability index.

resultsAmong 41 581 individuals (mean age 56.2 (SD: 12.8) years, 56.9% female), mean baseline HbA1c was 7.8% (SD: 1.9%) and 10 399 (25.0%) reported food insecurity. Food insecurity was associated with 0.1% greater HbA1c at 12 months, with little heterogeneity. For example, using GRF, the mean difference in HbA1c in the quartile with the lowest estimated HbA1c difference associated with experiencing, versus not experiencing, food insecurity was 0.0%, while the mean difference in the quartile with the greatest estimated difference was 0.2%. Results were similar for other outcomes, except that there was no association between food insecurity and LDL.

conclusionsIn this study, we did not observe meaningful heterogeneity in the associations between food insecurity and diabetes outcomes.

Indexed as

Diabetes Mellitus, Type 2Food InsecurityFood SupplyAdultAgedBlood PressureCholesterol, LDLFemaleGlycated HemoglobinHumansLongitudinal StudiesMaleMiddle AgedCholesterol, LDLGlycated HemoglobinBLOOD PRESSURECARDIOVASCULAR DISEASESDIABETES MELLITUSEPIDEMIOLOGYFOOD INSECURITY

Identifiers

PMID40681337
PMCPMC12359045

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.