NCT04034511

Brief Summary

Low-income adults are disproportionately affected by diabetes, experiencing greater rates of diabetes, diabetes-related complications, and mortality. Dietary habits play an important role in achieving and maintaining glycemic control to improve health outcomes. However, low-income adults are less likely to adopt the necessary dietary changes to improve glycemic control largely due to poor access to care, limited knowledge and skills to facilitate lifestyle change, and financial and environmental constraints that limit access to healthy foods. Nutrition interventions that target key barriers to healthy dietary habits among low-income adults with diabetes may have a profound impact on improving glycemic control. The provision of home-delivered, medically-tailored meals in addition to individualized medical nutrition therapy is a promising approach to improve dietary habits in socially disadvantaged populations with diabetes. Evidence suggests the provision of medically tailored meals may be beneficial in improving health outcomes and health care costs among socially disadvantaged adults with chronic illnesses, however rigorous studies specifically exploring the benefits of meal provision and medical nutrition therapy among adults with type 2 diabetes are lacking. The investigators aim to conduct a randomized-controlled clinical trial examining the impact of medically-tailored meals and medical nutrition therapy on health-related outcomes and health care costs among low-income adults with type 2 diabetes.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
74

participants targeted

Target at P25-P50 for not_applicable diabetes-mellitus-type-2

Timeline
Completed

Started Jan 2020

Longer than P75 for not_applicable diabetes-mellitus-type-2

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

July 24, 2019

Completed
2 days until next milestone

First Posted

Study publicly available on registry

July 26, 2019

Completed
6 months until next milestone

Study Start

First participant enrolled

January 21, 2020

Completed
2.7 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

October 4, 2022

Completed
12 months until next milestone

Study Completion

Last participant's last visit for all outcomes

September 30, 2023

Completed
Last Updated

October 10, 2023

Status Verified

October 1, 2023

Enrollment Period

2.7 years

First QC Date

July 24, 2019

Last Update Submit

October 9, 2023

Conditions

Keywords

nutritionmedically-tailored meals

Outcome Measures

Primary Outcomes (1)

  • Change in hemoglobin A1c

    Change in hemoglobin A1c (percent)

    Baseline, 6 months

Secondary Outcomes (1)

  • Change in Hemoglobin A1c

    Baseline, 12 months

Study Arms (2)

Medically-tailored meal delivery and medical nutrition therapy

EXPERIMENTAL

Participants assigned to this arm will receive home-delivered, medically-tailored meals for 3 months combined with monthly individual Medical Nutrition Therapy sessions for 6 months. Participants will also receive participants' usual case management services from participants' Medicaid insurance program.

Other: Medically-tailored meal delivery and medical nutrition therapy

Usual care

NO INTERVENTION

Participants assigned to this arm of the study will receive usual care and case management services from participants' Medicaid insurance program.

Interventions

Home-delivered, medically-tailored meals for 3 months combined with monthly individual medical nutrition therapy sessions for 6 months

Medically-tailored meal delivery and medical nutrition therapy

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Age 18 and over
  • Diabetes with a hemoglobin A1c\>8%
  • Medicaid beneficiary
  • Enrolled in Medicaid Insurance

You may not qualify if:

  • Medical conditions that are indications for additional dietary requirements (e.g., advanced chronic kidney disease, end-stage renal disease, chronic wounds, or severe alcohol use disorder)
  • Swallowing difficulties
  • Food allergies
  • Non-English speaking
  • Language or hearing impairment
  • Currently pregnant or breast feeding
  • Does not have a refrigerator/freezer in the home to store meals
  • Has plans to move out of the meal delivery service area in the next 12 months

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Johns Hopkins University School of Medicine

Baltimore, Maryland, 21205, United States

Location

Related Publications (1)

  • Clark JM, Maw MTT, Pettway K, Chander G, Elias S, Zisow-McClean S, Maruthur NM, Greer RC. Impact of Medically Tailored Meals on Clinical Outcomes Among Low-Income Adults with Type 2 Diabetes: A Pilot Randomized Trial. J Gen Intern Med. 2025 Jun;40(8):1711-1719. doi: 10.1007/s11606-024-09248-x. Epub 2024 Dec 13.

Related Links

MeSH Terms

Conditions

Diabetes Mellitus, Type 2

Interventions

Nutrition Therapy

Condition Hierarchy (Ancestors)

Diabetes MellitusGlucose Metabolism DisordersMetabolic DiseasesNutritional and Metabolic DiseasesEndocrine System Diseases

Intervention Hierarchy (Ancestors)

Therapeutics

Study Officials

  • Jeanne M Clark, MD, MPH

    Johns Hopkins University

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
OUTCOMES ASSESSOR
Masking Details
The outcome assessor and data-analyst will be masked to treatment assignment
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

July 24, 2019

First Posted

July 26, 2019

Study Start

January 21, 2020

Primary Completion

October 4, 2022

Study Completion

September 30, 2023

Last Updated

October 10, 2023

Record last verified: 2023-10

Data Sharing

IPD Sharing
Will not share

Locations