Despite boosting engagement with preventive healthcare, an intensive food-as-medicine program did not improve glycemic control in patients with uncontrolled type 2 diabetes (T2D) and self-reported food insecurity any better than usual medical care.

METHODOLOGY:

• A randomized clinical trial tested if an intensive food-as-medicine program improved glycemic control and affected healthcare use in patients with diabetes and food insecurity.
• The trial included 500 patients (81% White, 55% women, mean age, 55 years) with T2D, glycated hemoglobin (A1c) levels of ≥ 8%, food insecurity, and residence within the service area of the participating clinics.
• Patients were randomly assigned to either participate in the food-as-medicine program immediately (treatment group) or after 6 months (control group receiving usual care).
• The food-as-medicine program provided healthy groceries for 10 meals/week for the entire household, along with dietitian consultations, nurse evaluations, health coaching, and diabetes education.
• The primary outcome was participants’ A1c levels at 6 months, and secondary outcomes included healthcare use, self-reported diet, and healthy behaviors at both 6 months and 12 months.

TAKEAWAY:

• After 6 months, both the treatment and control groups reported a substantial decline in A1c levels (1.5 and 1.3 percentage points, respectively), with a nonsignificant adjusted mean difference of −0.10 (P = .57).
• Patients in the treatment group, as opposed to the control group, showed higher engagement with preventive healthcare at 6 months, making more visits to the program clinic (13.00 vs 0.72) and dietitians (2.7 vs 0.6).
• The number of outpatient visits, reflecting healthcare usage, was also significantly higher in the treatment vs control group at 6 months (P = .007).
• There was no detectable impact on total claims, with an insignificant reduction in inpatient or emergency department claims offset by an insignificant increase in outpatient claims.

IN PRACTICE:

“Programs targeted to individuals with elevated biomarkers require a control group to demonstrate effectiveness to account for improvements that occur without the intervention. Additional research is needed to design food-as-medicine programs that improve health,” the authors wrote.