Food-as-Medicine study finds no improvement in type 2 diabetes patients

Research led by the Sloan School of Management at the Massachusetts Institute of Technology in Cambridge found that an intensive program of diet as medicine showed no improvement in glycemic control in patients with type 2 diabetes and d food insecurity.

In their article titled “Effect of an Intensive Food as Medicine Program on Health and Health Care Utilization: A Randomized Clinical Trial,” published in JAMA Internal Medicine, the team details a randomized clinical trial involving 349 type 2 diabetic patients who previously experienced food insecurity to evaluate whether short-term access to healthy food options could improve glycemic control and influence healthcare utilization. health. An editor’s note from Deborah Grady on the study was published in the same issue of the journal.

The study targeted patients with type 2 diabetes and high HbA1c levels, providing them with intensive support and food provision. Subjects in the treatment group (n=170) received groceries for 10 healthy meals per week for the household, dietitian consultations, nursing assessments, health coaching, and diabetes education for one year with a followed by one year. A control group (n = 179) received no benefits from the treatment program for the first six months.

Hemoglobin A1C (HbA1c) tests six months after the start of the program showed substantial declines in the treatment (1.5%) and control (1.3%) groups, resulting in no differences significant between the groups. This could indicate that factors outside the program contributed to the drop in blood sugar levels, although the nature of these factors is unclear.

Access to the program actually increased engagement in preventative health care. More visits to a dietitian, active prescription medication orders, and improvement in self-reported diets were noted in the treatment group. These increases did not result in improved glycemic control compared to usual care in food insecure patients.

No significant differences between the treatment and control groups were observed in cholesterol, triglycerides, fasting blood sugar or blood pressure at six or 12 months. It is unclear why safe, healthy eating and increased access to healthcare professionals had no effect on any of these study measures.

The study appears to show that the damage caused by prolonged food insecurity is not easily reversed. It also suggests that any effort to help people struggling with food insecurity and diabetes cannot be aided by diet alone.

According to the Centers for Disease Control, people experiencing food and nutrition insecurity are two to three times more likely to have diabetes than others. A healthy diet is essential for managing blood sugar levels and can help prevent type 2 diabetes.

Nutritious foods can be expensive or difficult to find for people living below the poverty line, often leaving them dependent on calories from highly processed food sources. For people who already have diabetes, purchasing healthy foods can compete with healthcare costs for medications, devices, and supplies, creating a dire “treat” or “eat” scenario.

Although the study found no significant short-term improvements in the subjects recruited for the study, the problem of food and nutrition insecurity is worsening alongside an increase in diet-related chronic diseases.

Food-as-medicine programs are growing in popularity, with variations such as prescription product programs and medically tailored meals. The current study may suggest that a short-term intervention regimen is insufficient to create clinically measurable change and that longer-term food and nutrition security is necessary.

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