Improved Time in Range During 28 Days of Meal Delivery for People With Type 2 Diabetes

Abstract

Objective Nutrition therapy is a cornerstone of care for people with type 2 diabetes, yet starting new, healthy eating behaviors and sustaining them can be challenging. This decentralized, single-arm study assessed the impact of 28 days of home-delivered, pre-portioned meals (three meals per day) on continuous glucose monitoring (CGM)-derived glycemic control and quality of life. Research design and methods We enrolled 154 people with type 2 diabetes from across the United States. All participants were enrolled in a digital-first type 2 diabetes care center of excellence and had a time in range (TIR) <70% or a glucose management index (GMI) >7%. A total of 102 participants received another set of meals for a household member. Forty-four participants were excluded from CGM-based analysis because of sparse data in the baseline or intervention period. Results From the baseline through the intervention period, average TIR improved by 6.8% (95% CI 4.0–9.7, P <0.001), average GMI improved by 0.21% (95% CI 0.11–0.32, P <0.001), and participants’ odds of achieving ≥70% TIR increased (odds ratio 2.55 [95% CI 0.93–7.80, P = 0.051]). Although average TIR increased rapidly upon initiation of meal delivery, it regressed when the delivery period ended. Conclusion Home-delivered meals were associated with modest TIR and GMI improvements, but only in the short term. More research is needed to determine whether the effects of nutrition therapy can be extended by providing ongoing meal delivery or additional support such as behavioral intervention.

Food insecurity, SNAP participation and glycemic control in low-income adults with predominantly type 2 diabetes: a cross-sectional analysis using NHANES 2007–2018 data

“…If hypoglycemia alternates with hyperglycemia, an individual’s HbA 1c may not rise to a level that is considered poorly controlled. At least one study has demonstrated improvement in continuous glucose monitor (CGM) time in range during meal delivery for individuals with T2D, 48 and CGM has demonstrated an ability to differentiate individuals who have T2D or who are at risk or pre-DM in a predominantly Hispanic sample. 49 Thus, assessment of glycemic variability using CGM may be a better metric of control in future studies, although not available in national survey data.…”