Lowering HbA1c in Food Insecure Type 2 Diabetics through a Fruit and Vegetable Prescription Program.

Abstract

Abstract Objective – The effect of a six-month Fruit and Vegetable Prescription (FVRx) program on the HbA1c levels of food insecure diabetes in rural Washington was evaluated. Design – Participants were screened and recruited by their Primary Care Physician and referred to the FVRx program coordinator. Participants met with a diabetes health educator monthly where nutritional education was provided as well as SMART goal setting towards controlling their diabetes through an improved diet. Food vouchers for local farmers’ markets valued at $1 per day per household member were dispersed during these visits. The number of food vouchers redeemed were tracked for each participant for data analysis. HbA1c levels were measured before (May) and after (November) the program (n=14). Setting – A rural and medically underserved community: Skagit County, Washington. Participants – 14 food insecure diabetics with an HbA1c greater than 7% in the past three months. Results – The average HbA1c change was -1.85 (p = 0.0004; 95% CI: -2.69, -1.01) after the six-month program was completed. After adjusting for participants’ pre-program HbA1c level, a $10 increase in the average amount redeemed per month is associated with a 1.4% (p-value: 0.006; 95% CI: 0.5, 2.4) decrease in HbA1c. Conclusions – The Skagit County FVRx program’s participants showed significant improvements in their HbA1c levels. The results reveal a strong relationship between improving food security and improving diabetes management. A study with a larger number of participants as well as additional HbA1c measurements is needed for a clearer picture of this relationship.