(P312) Food Security Status in Pregnancy Complicated by Diabetes during COVID-19 and Diabetes Self-Care Behaviors

3 Key Takeaways of Your Research: The main take away from this research is that persons whose pregnancy is complicated by diabetes (pregestational and gestational) should be screened for food security, especially if multiple children reside in the household. It is important to explore any difficulties with ADCES self-care behaviors, specifically purchase and consumption of foods for the prescribed diet, purchase of self-monitoring supplies and ability to monitor as prescribed, and purchase of medication/supplies and ability to take medication as prescribed in persons reporting either food security or food insecurity. Lastly, referral to food assistance programs should be included in the diabetes care plan.

Background/Purpose: Household food insecurity (FI) during pregnancy is associated with poor pregnancy outcomes. The COVID-19 pandemic and associated public health orders not only disrupted patient access to care but may have also limited access to food. In pregnancy complicated by diabetes Food security (FS) status may further affect a person's ability to follow the ADCES7 self-care behaviors, including healthy diet, monitoring, and taking prescribed medications.

Research Hypothesis and/or Research Questions and Specific Aims: The aim of the proposed project was to examine the impact of food security status in pregnancy complicated by diabetes (pregestational and gestational) during the COVID-19 pandemic on patient self-care behaviors (eating a healthy diet, self-monitoring, taking prescribed medications) and pregnancy outcomes.

Methods/Methodology: A cross-sectional survey (English and Spanish) was sent electronically or by mail to patients with pregnancy complicated by diabetes (n=191) who received care at a university medical center from April 1, 2020 to March 31, 2021. Data included demographics, self-reported ADCES7 self-care behaviors, self-reported pregnancy outcomes, and food security status based on the USDA 18-item Household Food Security Survey Module.

Results: This cross-sectional survey was sent to patients whose pregnancy was complicated by diabetes (n=191, 12% return rate) during the COVID-19 pandemic. Twenty-two percent (n=5) of survey respondents had FI and 78% (n=18) had FS. Households with FI, were significantly larger with more children residing in the household compared to households with FS. There were no statistically significant differences in self-care behaviors between FI and FS households, although FI households were more likely to report difficulty purchasing and consuming foods on the prescribed diet (p=0.06). Both groups reported some difficulty with monitoring and medications. No significant differences in delivery type or maternal and fetal outcomes were observed between groups.

Conclusions (Impact on Diabetes Care and Education): This cross-sectional study did not find that food security status during COVID-19 had a significant impact on self-care behaviors in women whose pregnancy was complicated by diabetes. The finding that 43% to 50% of patients with FS reported difficulty purchasing foods for the prescribed diet, self-monitoring supplies, and medication/medication management is concerning and warrants further investigation. CDCES should consider screening this population for food security.

Source of Funding for this Research: This study was funded by a University of New Mexico College of Education and Human Sciences mini-grant.

Authors: Diana Gonzales-Pacheco, DCN, RDN, University of New Mexico, Albuquerque, NM, Jacquelyn Blackstone, DO, University of New Mexico, Albuquerque, NM, Kripa Dhungana, BT, University of New Mexico, Albuquerque, NM