Association of Food Pharmacy Participation with Type II Diabetes Mellitus Risk Factors
Abstract Objectives Food insecurity poses a public health threat in a number of concerning ways, including increased risk of Type 2 Diabetes Mellitus (T2DM). A number of safety-net resource sites in the US are working to address this complex relationship through the disbursal of medically tailored food to clients with T2DM, sometimes referred to as a “food pharmacy”. Our study aimed to determine if participation by food insecure individuals in a food pharmacy affected clinical markers of T2DM status or risk, namely glycated hemoglobin (HbA1c), fasting blood glucose (FBG), or body mass index (BMI). Methods We conducted a retrospective study of data from a food pharmacy run by a safety-net healthcare clinic in California. Data from January 2016 through May 2019 were analyzed. Patients with T2DM were referred to the food pharmacy by clinic physicians. After referral, patients could pick up boxes of diabetes appropriate food (contents were determined by program staff and varied based on food availability) once a week. Results from participant's successive biomedical tests were recorded by clinic staff. Participants with a baseline measurement of HbA1c, FBG, or BMI within ±11 days of food pharmacy referral and at least one subsequent measurement of the same variable qualified for inclusion (n = 161). Participation rate was defined as the proportion of food pickup opportunities attended by each individual. Spearman correlation analysis, t-tests, and analyses of variance were conducted to determine the association between program participation on HbA1c, FBG, and BMI. Results At 24 months, increased food pharmacy participation correlated with a reduction in BMI (r = –0.39, P = 0.03, n = 29). As compared with those who participated below the median rate, the “high participation” group had a lower mean BMI at 24 months (34.6 ± 9.1 vs 29.1 ± 4.9 kg/m2, P = 0.05). Mean HbA1c was lower at 18 months as compared to baseline (9.1 ± 2.3 vs 8.2 ± 1.8%, P = 0.04). However, HbA1c and FBG were not correlated with participation rate. Conclusions This study found higher food pharmacy participation rates are associated with reductions in BMI, but not HbA1c or FBG. Food pharmacies may need to reevaluate their treatment model if they are to effectively target T2DM in food insecure individuals. Funding Sources None.