Mona Maddahi - Department of Nutrition, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Soheil Asadimehr - Department of Nutrition, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Amirhossein Ramezani Ahmadi - Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan,Iran
Fatemeh Govahi Kakhki - Department of Nutrition, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
Reza Sobhani - Department of Nutrition, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

Background: Food insecurity is an important global challenge associated with various health problems such as diabetes. Diabetes mellitus is one of the most common metabolic diseases and is considered priority in Iran’s health system. The aim of this study is to evaluate the relationship between food insecurity and type ۲ dibetes mellitus (T۲DM) in Iran. Methods: The authors searched English databases including Scopus, Web of Science, PubMed, and Google Scholar and also Iranian databasesof SID and Magiran for the words food insecurity, Iran, and diabetes up to November ۲۰۲۱. Results: ۸ articles, including ۲۸۵۳ participants, ranging from ۱۴۸ to ۴۴۰ were included in the meta-analysis. The pooled odds ratios (ORs) of the cross-sectional  and  case-control studies revealed that household food insecurity was significantly associated with the odds of diabetes (OR=۲.۰۴; ۹۵% CI: ۱.۳۴- ۳.۰۹) and there was no evidence for publication bias (Egger’s test, P = ۰.۵۹); however, heterogeneity between studies (I۲=۸۵.۹%) was observed. Similarly, according to subgroup analyses based on age, there was a significant association between household food insecurity and diabetes among the people under ۵۰ years (OR= ۲.۹; ۹۵% CI: ۲.۱۳-۳.۹۳; I۲ = ۵۶.۴%, P=۰.۰۵۷), but not among people over ۵۰ years (OR=۱.۳۲; ۹۵% CI: ۰.۶۹-۲.۵۲; I۲ = ۷۸.۳%, P=۰.۰۳۲) or between ۳۰ and ۶۵ years (OR=۰.۸۵; ۹۵% CI: ۰.۴۹-۱.۴۸). Conclusion: This study shows that food insecurity affects the progression of type ۲ DM. However, more longitudinal studies are needed for better identification of the link between food insecurity and T۲DM.

Food insecurity, Food security, Diabetes mellitus, Iran.