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      Food Insecurity and Diabetes: Overview of Intersections and Potential Dual Solutions

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      1 , , 2 , 1
      Diabetes Care
      American Diabetes Association

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          Abstract

          Food insecurity increases the risk of developing diabetes and its complications. In this article, we describe the complex relationship that exists between food insecurity and diabetes and describe potential mechanisms that may underlie this association. We then describe how two different types of interventions, food-is-medicine and federal nutrition assistance programs, may help address both food insecurity and health. Finally, we outline the research, policy, and practice opportunities that exist to address food insecurity and reduce diabetes-related health disparities.

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          Social Determinants of Health and Diabetes: A Scientific Review

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            Depression and Type 2 Diabetes Over the Lifespan

            OBJECTIVE—It has been argued that the relationship between depression and diabetes is bi-directional, but this hypothesis has not been explicitly tested. This systematic review examines the bi-directional prospective relationships between depression and type 2 diabetes. RESEARCH DESIGN AND METHODS—A search was conducted using Medline for publications from 1950 through 2007. Reviewers assessed the eligibility of each report by exposure/outcome measurement and study design. Only comparative prospective studies of depression and type 2 diabetes that excluded prevalent cases of depression (for diabetes predicting depression) or diabetes (for depression predicting diabetes) were included. Two sets of pooled risk estimates were calculated using random effects: depression predicting type 2 diabetes and type 2 diabetes predicting depression. RESULTS—Of 42 full-text publications reviewed, 13 met eligibility for depression predicting onset of diabetes, representing 6,916 incident cases. Seven met criteria for diabetes predicting onset of depression, representing 6,414 incident cases. The pooled relative risk (RR) for incident depression associated with baseline diabetes was 1.15 (95% CI 1.02–1.30). The RR for incident diabetes associated with baseline depression was 1.60 (1.37–1.88). CONCLUSIONS—Depression is associated with a 60% increased risk of type 2 diabetes. Type 2 diabetes is associated with only modest increased risk of depression. Future research should focus on identifying mechanisms linking these conditions.
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              Prevention and management of type 2 diabetes: dietary components and nutritional strategies.

              In the past couple of decades, evidence from prospective observational studies and clinical trials has converged to support the importance of individual nutrients, foods, and dietary patterns in the prevention and management of type 2 diabetes. The quality of dietary fats and carbohydrates consumed is more crucial than is the quantity of these macronutrients. Diets rich in wholegrains, fruits, vegetables, legumes, and nuts; moderate in alcohol consumption; and lower in refined grains, red or processed meats, and sugar-sweetened beverages have been shown to reduce the risk of diabetes and improve glycaemic control and blood lipids in patients with diabetes. With an emphasis on overall diet quality, several dietary patterns such as Mediterranean, low glycaemic index, moderately low carbohydrate, and vegetarian diets can be tailored to personal and cultural food preferences and appropriate calorie needs for weight control and diabetes prevention and management. Although much progress has been made in development and implementation of evidence-based nutrition recommendations in developed countries, concerted worldwide efforts and policies are warranted to alleviate regional disparities. Copyright © 2014 Elsevier Ltd. All rights reserved.
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                Author and article information

                Journal
                Diabetes Care
                Diabetes Care
                diabetes care
                Diabetes Care
                American Diabetes Association
                0149-5992
                1935-5548
                September 2023
                24 June 2023
                24 June 2023
                : 46
                : 9
                : 1599-1608
                Affiliations
                [1 ]Division of General Internal Medicine, University of California San Francisco, San Francisco, CA
                [2 ]Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA
                Author notes
                Corresponding author: Ronli Levi, ronli.levi@ 123456ucsf.edu
                Author information
                https://orcid.org/0000-0001-6915-4903
                Article
                i230002
                10.2337/dci23-0002
                10465985
                37354336
                524cde1a-ffb8-49dd-99bd-7cab1118f47b
                © 2023 by the American Diabetes Association

                Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at https://www.diabetesjournals.org/journals/pages/license.

                History
                : 14 February 2023
                : 24 April 2023
                Funding
                Funded by: National Institute of Diabetes and Digestive and Kidney Diseases, DOI 10.13039/100000062;
                Award ID: 2P30 DK092924
                Funded by: Centers for Disease Control and Prevention, DOI 10.13039/100000030;
                Award ID: U18DP006526.
                Categories
                Diabetes Care Symposium

                Endocrinology & Diabetes
                Endocrinology & Diabetes

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