Early Trial Shows Promise for Medically Tailored Meals in Type 2 Diabetes

Quick Take for Physicians: In a pilot RCT, adults with type 2 diabetes receiving 10 MTMs/week for 12 weeks plus dietitian counseling showed meaningful improvements in food security and engagement with care.

HbA1c shifted modestly (−0.3%) and non-significantly—expected for a small, short pilot—but the behavioral and social improvements justify larger, longer outcome-driven trials.
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Study Design

Published in Journal of General Internal Medicine (2024), Medicaid-insured adults with type 2 diabetes (baseline HbA1c ≥7.5%) and food insecurity were randomized to:

• Intervention: 10 medically tailored meals/week × 12 weeks + monthly RD telehealth
• Control: Usual care with standard nutrition materials

🔗 Read full study →
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Key Results

• Food security: Significant improvement vs. control on the USDA module
• Engagement: Higher rates of completed diabetes and primary care visits
• Glycemia: HbA1c improved modestly (~−0.3%) but not statistically significant
• Acceptability: High satisfaction with meals and perceived support for daily self-management
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Why This Matters

Food insecurity undermines diabetes control and adherence.
By addressing this directly through medically tailored meals, patients gain stable nutrition, satiety, and protein adequacy, which supports self-management and consistent engagement in care—key foundations for long-term HbA1c improvement.
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How to Implement in Practice

Pragmatic Physician Pathway

1. Screen for food insecurity (Hunger Vital Sign) and low diet quality.
2. Prescribe ~10 diabetes-tailored meals/week for 12 weeks—prioritize fiber, lean protein, and carb consistency.
3. Pair with RD telehealth every 2–4 weeks to troubleshoot adherence and adjust goals.
4. Track outcomes: food security, visit completion, HbA1c/CGM time-in-range, weight, and BP.
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Operational & Payer Considerations

• Coverage: Use HSA/FSA funds where possible; explore Medicaid pilots or MA supplemental benefits for eligible members.
• Workflow: Embed MTM referrals in diabetes order sets; automate RD follow-ups.
• Equity: MTMs can close nutrition access gaps for patients with limited cooking facilities or transportation.

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Fast onboarding • Evidence-aligned menus • Outcome tracking
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FAQs

Who is the best candidate?

Adults with type 2 diabetes (HbA1c ≥7.5%) who screen positive for food insecurity or struggle with meal planning or cooking.
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What “dose” should we start with?

~10 meals/week for 12 weeks is practical and well-tolerated; increase to 14/week for patients with significant functional or access barriers.
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Which outcomes should we track?

Food security status, visit completion, HbA1c or CGM metrics, weight, BP, and patient-reported adherence and satiety.