Grant: Project Grant

Background: Individuals who have diabetes have high blood sugar levels. When patients with diabetes' sugars remain high, they are at risk of heart attacks, kidney failure, amputations, and blindness. An important part of lowering blood sugars is following a healthy diet that includes whole grains, fruits, vegetables, fish, and whole grains. Unfortunately, these foods are often more expensive than more highly processed unhealthy foods. Many Canadians are unable to afford to eat healthy foods, a condition known as food insecurity. In patients with diabetes, food insecurity often results in high blood sugars. Healthcare providers have very few options to help address food insecurity in their patients with diabetes. Healthy food subsidies, prescribed by doctors, may be a new solution. Goals: We will study whether those who receive a subsidized healthy food prescription have lower blood sugar levels compared to those who don't receive the subsidy. We will also study how receiving food subsidies may affect patient health and health care costs in the longer-term. Methods: A total of 800 adults (>18 years) with type 2 diabetes, high blood sugars, and food insecurity will be randomized to either receive either: (A) a healthy food prescription; or (B) a healthy food prescription and a 12-month healthy food subsidy of $1.50/day/household member (~$170/month for a household of 4), which can be used to buy healthy foods. We will assess differences between the two groups in blood sugars, blood pressure, cholesterol, body mass index, diet quality and food insecurity. We will also estimate the long-term effects of the food subsidies on patients' health and health care costs. Expected results: This research will help us to understand if healthy food prescription programs should be offered more broadly to help patients with diabetes and food insecurity.