Impact of a diabetes-designed meal delivery service on changes in hemoglobin A1c and quality of life in patients with diabetes

Bryan A Farford; Brian J Eglinger; Lindsey Kane; James N Gilbert; Colleen T Ball

doi:10.1016/j.dsx.2024.103004

Impact of a diabetes-designed meal delivery service on changes in hemoglobin A_1c and quality of life in patients with diabetes

Diabetes Metab Syndr. 2024 Apr 15;18(4):103004. doi: 10.1016/j.dsx.2024.103004. Online ahead of print.

Authors

Bryan A Farford¹, Brian J Eglinger², Lindsey Kane², James N Gilbert², Colleen T Ball²

Affiliations

¹ Department of Family Medicine (Farford), Department of Research (Eglinger), and Department of Quantitative Health Sciences (Ball), Mayo Clinic, Jacksonville, FL, USA; Director of Nutrition (Kane), Sunbasket, Philadelphia, PA, USA; Chief Medical Officer (Gilbert), Aspire Health Plan, Monterey, CA, USA. Electronic address: Farford.Bryan@mayo.edu.
² Department of Family Medicine (Farford), Department of Research (Eglinger), and Department of Quantitative Health Sciences (Ball), Mayo Clinic, Jacksonville, FL, USA; Director of Nutrition (Kane), Sunbasket, Philadelphia, PA, USA; Chief Medical Officer (Gilbert), Aspire Health Plan, Monterey, CA, USA.

PMID: 38626649
DOI: 10.1016/j.dsx.2024.103004

Abstract

Background: Over 34 million Americans have diabetes, and nutrition therapy is essential in self-management.

Aims: The primary aim of the study was to evaluate the impact of meals designed for patients with type 2 diabetes (T2D) through a meal delivery program. The primary outcome was a 3-month change in hemoglobin A_1c (HbA_1c). Secondary outcomes included a 3-month change in weight, blood pressure, high-density lipoprotein, low-density lipoprotein, and triglycerides. Furthermore, the study aimed to evaluate the impact of the meal delivery program on the participants' quality of life.

Methods: In this randomized crossover clinical trial, patients were allocated in a 1:1 fashion to treatment sequence AB or treatment sequence BA. In Phase 1, participants allocated to sequence AB received 10 meals per week for 3 months, followed by a 3-month washout period and a 3-month standard intervention period with no meals. Participants allocated to sequence BA received 3 months of standard intervention with no meals followed by a 3-month washout period and a 3-month period with 10 meals per week. A quality-of-life survey was obtained during weeks 0, 12, 24, and 36.

Results: The mean 3-month change in HbA_1c (primary outcome) was nearly a half point lower with meal delivery (-0.44% [95% CI: -0.85%, -0.03%]; P = 0.037). The estimated mean 3-month change in quality of life was approximately 2 points lower (better) with meal delivery (-2.2 points [95% CI: -4.2, -0.3]; P = .027). There were no statistically significant differences in secondary outcomes with meal delivery (all P ≥ 0.15).

Conclusions: A meal delivery system for patients with T2D improves glycemic control and quality of life.

Keywords: Glycated hemoglobin A; Meals; Nutrition therapy; Quality of life.