LAUSR

Food insecurity (FI) is higher among Latinos than non-Hispanic Whites and associated with risk for type 2 diabetes (T2D). Autonomic nervous system (ANS) dysfunction increases mortality in diabetes. We examined FI and ANS function among Latinos with T2D. Participants were drawn from the CALMS-D (Community Health Workers Assisting Latinos Manage Stress and Diabetes) stress management intervention trial. Inclusion: age 18 years, Latino or Hispanic, Spanish speaking, ambulatory status, T2D 6 months, A1c > 7.0%. Exclusion: medical or psychiatric instability; pain or dysfunction in hands precluding handgrip testing. Measures: FI was assessed with the 6-item US household food security survey module; affirmative responses to > = 1 questions was coded as FI. Six autonomic measures were scored 0 = normal or 1 = abnormal based on published cutoffs and then summed for a total ANS dysfunction index. ANS measures and their normal cutoffs were: 1) metanephrine <350 ug/day; 2) normetanephrine <600 ug/day; 3) cortisol 50–190 ug/day, all from 24-hour urine specimens; 4) 24-hour heart rate variability as reflected in standard deviation of the normal-to-normal (SDNN) heart rate acquired with 3-channel, 7-lead ambulatory electrocardiogram (holter) monitors, 149 +/–39; 5) difference between the highest diastolic blood pressure (DBP) during sustained handgrip and the average DBP at rest, >15 mmHg; and, 6) difference between baseline supine and the minimal BP after standing up, normal = decline in SBP <=20 mmHg and DBP <=10 mmHg. N = 35 participated, n = 23 (65.7%) were women, age M = 61.6 (SD = 11.2) years, A1c M = 8.5% (SD = 1.6) and n = 20 (57.1%) used insulin. N = 22 (62.9%) reported FI and n = 25 (71.4%) had at least one abnormal ANS measure. In t-tests, participants with FI had a higher ANS dysfunction index (M = 1.5, SD = 0.9) than patients who were food secure (M = 0.7, SD = 0.8), P = 0.02). Total autonomic index was not related to A1c or insulin use. In this Latino sample with T2D, FI was associated with greater ANS dysfunction. Increasing food security may confer autonomic benefits. Supported by National Institute on Minority Health and Health Disparities grant R01MD005879 and American Diabetes Association grant 7–13-TS-31.