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Background: Food insecurity is a growing challenge in low- and middle-income countries and may worsen outcomes in individuals with type 2 diabetes mellitus (T2DM). This study sought to assess the relationship between food security, glycemic status, lipid profile, and lifestyle factors among individuals receiving standard diabetes care in the Tafo Municipality, Kumasi.
Methods: In a cross-sectional study of 52 adult patients with T2DM, food security, dietary intake, physical activity, and psychosocial stress were measured using validated questionnaires. Anthropometric (BMI, waist circumference, body fat, visceral fat) and biochemical indices (fasting blood glucose (FBG), HbA1c, lipid profile) were assessed. Dietary patterns were derived by principal component analysis. Associations were evaluated using correlation tests.
Results: Overall, 57.7% of participants were food insecure, while 31% reported moderate to high psychosocial stress. Poor glycemic control was observed in 40.4% of participants. There was a significant positive correlation between psychosocial stress and HbA1c (r = 0.283, p = 0.042). There was also a significant positive correlation between visceral fat and FBG (r = 0.331, p = 0.016). A significant negative correlation was observed between food security and HDL cholesterol (r = -0.345, p = 0.012) while physical activity also correlated negatively with LDL (r = -0.303, p = 0.029). Food security showed no significant correlation with HbA1c (r = -0.226, p = 0.107). There were four main dietary patterns among the participants: plant-based/vegetable-rich, starchy and high-fat, sugary and animal-based, and fruit-dominant patterns.
Conclusion: Poor glycemic control, food insecurity, and psychosocial stress were prevalent among the study participants. Psychosocial stress seems to influence glycemic control among the participants. Integrated strategies to improve food security, reduce stress, and promote healthier diets may enhance glycemic control and reduce cardiometabolic complications among individuals living with T2DM in this setting.