Department of Obstetrics and Gynecology, Christiana Care Health System, Newark, Delaware.
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Am J Perinatol. 2023 Jun;40(8):825-832. doi: 10.1055/s-0041-1740194. Epub 2021 Nov 28.
Gestational and pregestational diabetes during pregnancy are substantial and growing public health issues. Low-income individuals and individuals who identify as racial and ethnic minorities are disproportionately affected. Food security, which is defined as the degree to which individuals have capacity to access and obtain food, is at the center of nutritional resources and decisions for individuals with diabetes. While increasingly recognized as an important mediator of health disparities in the United States, food insecurity is understudied during pregnancy and specifically among pregnant individuals with diabetes, for whom the impact of food-related resources may be even greater. Previous research has suggested that food insecurity is associated with type 2 diabetes mellitus diagnoses and disease exacerbation in the general adult population. An emerging body of research has suggested that food insecurity during pregnancy is associated with gestational diabetes mellitus diagnoses and adverse diabetes-related outcomes. Additionally, food insecurity during pregnancy may be associated with adverse maternal and neonatal outcomes. Future research and clinical work should aim to further examine these relationships and subsequently develop evidence-based interventions to improve diabetes-related outcomes among pregnant individuals with food insecurity. The purpose of this article is to offer a working definition of food security, briefly review issues of food insecurity and diabetes, summarize research on food insecurity and diabetes-related pregnancy health, and discuss clinical recommendations and areas for future investigation. KEY POINTS: · Research on food insecurity and diabetes-related health is limited.. · The impact of food security on diabetes management and obstetric outcomes is likely significant.. · Future work to evaluate perinatal food security screening is warranted..
妊娠期和孕前糖尿病是严重且日益严重的公共卫生问题。低收入人群和少数族裔人群受到的影响不成比例。食品安全是指个人获取和获得食物的能力程度，是糖尿病患者营养资源和决策的核心。尽管食品安全在美国被认为是健康差距的一个重要中介因素，但在怀孕期间，特别是在患有糖尿病的孕妇中，食品安全问题研究不足，因为与食物相关的资源对她们的影响可能更大。先前的研究表明，食品安全与 2 型糖尿病的诊断和成年人中疾病的恶化有关。越来越多的研究表明，妊娠期的食品安全与妊娠期糖尿病的诊断和不良的糖尿病相关结局有关。此外，妊娠期的食品安全问题可能与母婴不良结局有关。未来的研究和临床工作应该旨在进一步研究这些关系，并随后制定基于证据的干预措施，以改善患有食品安全问题的孕妇的糖尿病相关结局。本文的目的是提供食品安全的工作定义，简要回顾食品安全和糖尿病问题，总结有关妊娠期食品安全和糖尿病相关健康的研究，并讨论临床建议和未来研究领域。要点：· 关于食品安全和糖尿病相关健康的研究有限。· 食品安全对糖尿病管理和产科结局的影响可能很大。· 有必要对围产期食品安全筛查进行未来研究。
