ABSTRACT
Food insecurity is a growing public health concern in the United Kingdom (UK), with significant implications for adults living with type 2 diabetes. This systematic review explores how clinicians can identify and support food-insecure adults in diabetes care settings. A clinician is defined as a healthcare professional who provides direct patient care. Four databases (MEDLINE, Embase, CINAHL, APA PsycINFO) and grey literature sources were searched. Eleven qualitative and mixed-methods studies from the United States (US), Canada, and the UK were included. Using thematic synthesis, three analytical themes were developed. The first theme highlights that identifying food insecurity requires organisational support and buy-in. Clinicians recognised the importance of routine screening, but systemic barriers such as time constraints, lack of referral pathways, and limited integration into existing workflows hindered implementation. The second theme emphasises the role of trust-based clinical relationships in enabling disclosure and patient engagement. Empathy and stigma-sensitive communication were found to be essential for patients to feel safe discussing food insecurity and engaging with care plans. However, unrealistic dietary advice and limited clinician awareness of social needs undermine these efforts. The third theme identifies the need for collaboration with community organisations. Clinicians reported limited knowledge of local food support services and emphasised the importance of system-led referral pathways and partnerships to address food insecurity effectively. Patients also highlighted challenges such as low food literacy and poor cooking skills, reinforcing the need for practical, community-based support. Addressing food insecurity in type 2 diabetes care requires more than individual clinician effort, it demands coordinated action across healthcare and community sectors to improve health outcomes and reduce inequalities. This review calls for a systems thinking approach to diabetes care that integrates structural reform, relational care, and community collaboration.
Journal of Human Nutrition and Dietetics, Volume 39, Issue 1, February 2026. Read More