We shouldn’t have to choose.

By Katherine English

Picture this. You’ve recently been diagnosed with Type 2 Diabetes. Your doctor prescribes you with a medication. You meet with a Dietitian who gives you all sorts of education on how to eat, encouraging fresh fruits and veggies, whole grains, etc. The Dietitian also stresses the importance of checking your blood sugars often. This is all very overwhelming to begin with, except there is one other thing you can’t get out of your mind. You aren’t even sure how you are going to feed your kids, let alone yourself, for the rest of the month. How will you even begin to self-manage your diabetes? How will you cope with this new stressor?

Food security is a very real issue in Canada. The 2014 report on Household food insecurity in Canada indicates that around 1.3 million households experience food insecurity1. This means they do not “have physical and economic access to sufficient, safe and nutritious food to meet their dietary needs and food preferences for an active and healthy life.”2

Only a portion of food insecure individuals access food banks3. Many people who are food insecure are actually wage-based income earners4.  This brings to light the fact that current services are not meeting the needs of a large portion of the population.

Research has shown that people who are food insecure and have diabetes have poorer self-management4,5,6. Poor management of blood sugars increases risk for long term complications, like decrease in kidney function or vision4,5,6.

Furthermore, the Canadian Diabetes Association (CDA) highlights that many Canadians don’t have insurance that can cover costs of monitoring supplies or medications7 and they often have to choose between food and medications, or between food and rent. Diabetes costs the healthcare system billions of dollars and this is only expected to continue rising7

When it comes down to it, poverty is at the root of many health related issue. In regards to diabetes, the CDA7 states that

the prevalence of modifiable risk factors decreases as education and income levels increase (p.8)

We need to start addressing the root causes of health inequity. People shouldn’t have to choose between food and rent. We need to look to solutions that tackle poverty, such as a guaranteed annual income. Most importantly, these interventions must be sustainable and equitable.


Katherine English is an MPH Nutrition and Dietetics student at the University of Toronto.






1. Tarasuk V, Mitchell A, Dachner N. Household food insecurity in Canada, 2014. Research to Identify Policy Options to Reduce Food Insecurity (PROOF). Toronto. 2016. Available from: http://proof.utoronto.ca/resources/proof-annual-reports/annual-report-2014/

2. United Nations Food and Agriculture Organization (1996), Rome Declaration on World Food Security, World Food Summit Plan of Action, paragraph 1, Rome: November 1996. Available at: http://www.fao.org/docrep/003/w3613e/w3613e00.htm, Accessed 9/15/2016

3. Rouse V. The Diabetes Communicator Newsletter. 2015. http://www.diabetes.ca/publications-newsletters/the-diabetes-communicator-newsletter/the-diabetes-communicator-archive/the-diabetes-communicator-winter-2014-issue/articles/food-insecurity-and-diabetes

4. Heerman WJ, Wallston KA, Osborn CY, Bian A, Schlundt DG, Barto SD, Rothman RL. Food insecurity is associated with diabetes selfcare behaviours and glycaemic control. Diabetic Medicine. 2015 Oct 1.

5. Chan J, DeMelo M, Gingras J, Gucciardi E. Challenges of Diabetes Self-Management in Adults Affected by Food Insecurity in a Large Urban Centre of Ontario, Canada. International journal of endocrinology. 2015 Oct 20;2015.

6. Silverman J, Krieger J, Kiefer M, Hebert P, Robinson J, Nelson K. The relationship between food insecurity and depression, diabetes distress and medication adherence among low-income patients with poorly-controlled diabetes. Journal of general internal medicine. 2015 Oct 1;30(10):1476-80.

7. Canadian Diabetes Association. Summary Report: 2015 Report on Diabetes- Driving Change [Internet].Canadian Diabetes Association, 2016; [cited 2016Jul29]. Available from: http://www.diabetes.ca/getmedia/5b2c2d2a-81da-4bf9-88ad-f4688d0d2530/2015-report-on-diabetes-driving-change-summary-english.pdf.aspx