Managing type 2 diabetes is about much more than taking medicine. Healthy food is one of the most important parts of controlling blood sugar, but many people struggle to afford nutritious meals.
A new study suggests that helping people buy healthy groceries may improve diabetes control as well as food security. The findings were published in Circulation.
Type 2 diabetes develops when the body cannot use insulin properly, causing blood sugar levels to remain too high. Over time, high blood sugar can damage the heart, kidneys, eyes and nerves. Doctors often measure long-term blood sugar using a test called hemoglobin A1c, or HbA1c, which reflects average blood sugar over the previous two to three months.
Researchers from Kaiser Permanente Southern California enrolled 460 adults with type 2 diabetes who had Medicaid insurance and elevated HbA1c levels. All participants also faced social or financial challenges that could make it harder to eat healthy foods.
Participants were randomly assigned to receive either usual medical care or medically tailored groceries for six months. People in the grocery groups received healthy foods worth about $100 to $210 each month depending on the program. They also received recipes and nutrition counselling through telehealth.
At the end of the study, blood sugar control improved more in the grocery groups than in the usual-care group. Average HbA1c fell by 0.66 percentage points in people receiving medically tailored groceries, compared with a 0.25-point reduction in those receiving standard care alone.
Both the lower-value and higher-value grocery programs produced similar improvements. This suggests that even moderate support with healthy food may help people better manage diabetes.
The benefits were not limited to blood sugar. Participants were much more likely to report having enough healthy food available at home and feeling confident they could maintain a nutritious diet. However, body weight and blood pressure did not change significantly during the six-month study.
The researchers found similar results regardless of sex, education level or starting blood sugar levels. The improvements also remained after accounting for differences in health conditions, medicines and other personal factors.
The researchers believe healthy food should be considered an important part of diabetes treatment, especially for people facing financial hardship. When nutritious foods become easier to access, patients may find it easier to follow medical advice and maintain stable blood sugar levels.
This randomized clinical trial provides stronger evidence than most nutrition studies because participants were randomly assigned to treatment groups.
However, the study lasted only six months, so it is unclear whether the benefits continue over many years. Future research should examine long-term health outcomes and whether similar programs reduce diabetes complications and healthcare costs.
Source: Circulation.
