Dr. Hilary Seligman, Lead Scientist for Feeding America
November 3, 2015
by Dr. Hilary Seligman

It is well known that there is an epidemic of diabetes in the U.S. Almost 10% of Americans currently have diabetes, although more than a quarter of those don’t even know they have it. Even worse, rates of diabetes will likely continue their extraordinarily steep climb if we don’t do something about it. In fact, the CDC estimates that 20-30% of the U.S population will have diabetes by 2050. 

Of all the common diseases I treat as a primary care doctor at San Francisco General Hospital, diabetes is one of the most difficult for patients to deal with. There are the medications (often six medications or more!) that have to be taken two and sometimes three times every single day. Some of the medications—insulin in particular—don’t come as pills. These medicines have to be injected under the skin using a syringe and a needle, often multiple times a day. But even after all the medication, you can’t ever forget you have diabetes because everything you eat and all the time you spend sitting (in front of the computer, at the dinner table, or on the bus) impacts your diabetes. 

As a primary care doctor, I urge my patients with diabetes at every visit to never miss a medication dose, to eat more healthy foods and to get more physical activity. But this is hard work for people to do, day in and day out, every day. Imagine yourself with diabetes. Would you be able to take a handful of medications twice a day without ever missing a dose? Would you be able to make vegetables the center of every meal? Would you be able to exercise every single day?

Now imagine trying to follow these instructions if you could barely make ends meet. What would you do if you had to choose between paying for your next meal and paying your co-payment at the pharmacy?  What would you do if your money for food was gone at the end of the month, and you had to eat whatever was left in the cupboard whether it was good for your diabetes or not?  These are choices that food insecure Americans with diabetes are making every day, and it makes the stress of having diabetes that much greater.

Although diabetes support has traditionally occurred only in the doctor’s office, the Feeding America network of food banks recognizes that they can play an important role in helping clients to manage their diabetes. Why? First, because we bring food. A third of all Feeding America clients tell us that someone in their household has diabetes. That means we are bringing food to an awful lot of people with diabetes, people for whom the food they eat plays a critical role in their health. Second, our network reaches a lot of people who don’t have premier medical access. They may lack insurance completely, or there may be a shortage of health care providers in their neighborhood who accept their insurance, or their work schedules may make it challenging to reach their clinic. Offering diabetes support in food pantries brings diabetes support to them—rather than waiting for patients to come to us at the clinic. 

This is why we are so excited today to share the results of our first formal evaluation of diabetes support provided at the food pantry. In partnership with Redwood Empire Food Bank, Mid-Ohio Foodbank, and The Food Bank of Corpus Christi, we brought diabetes support to almost 700 people with diabetes that we serve at food pantries in the form of diabetes-appropriate food, blood sugar monitoring, diabetes education and referrals to primary care. It should come as little surprise that it worked! The people we served at food pantries who participated in the diabetes program ate more fruits and vegetables, took their medication more reliably, were less distressed about their diabetes and had better blood sugar control. A special thank you to The Bristol-Myers Squibb Foundation for funding the initial Diabetes Pilot through their Together on Diabetes initiative.

Thanks to support from the Laura and John Arnold Foundation, a more formal evaluation of our diabetes program is currently underway. This new research project will help us better demonstrate the impact we can have on the health of the people we serve by providing food, education, emotional support and links to primary care at the food pantry.

There are an enormous number of people in America who are struggling to control their diabetes, and Feeding America reaches a whole lot them with food. Today we can say that we are capable of providing not just food, but broad diabetes support that makes a difference in people’s lives. 

*Dr. Hilary Seligman, MD, MAS, serves as lead scientist and senior medical advisor at Feeding America. She also serves as an associate professor in residence at University of California San Francisco (UCSF) and is a faculty member at the Center for Vulnerable Populations at San Francisco General Hospital.

Tags: Innovative Solutions to Hunger , Our Research

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