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

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.