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For diabetics, a good diet can be better than medicines

Written by Diane Archer

An article in NEJM Catalyst describes a new disease management trial at Geisinger Health System. Geisinger is testing providing free food to patients with diabetes who were not eating a balanced diet, as a medicine. It recognizes that a good diet can be better than medicines or at least reduce the need for drugs.

As of March 2018, Geisinger has enrolled 112 food-insecure patients with diabetes in its pilot program. More than one in 10 Americans  (11.3 percent of Pennsylvanians) have diabetes. Geisinger designed this trial because food insecurity is often a trigger for diabetes. And more than one in eight Americans are food insecure.

Food insecurity, in Geisinger’s program, means that people worried that their food would run out before they could afford more. Or, they could not afford to buy food so went without.

Geisinger offers the diabetics in its trial healthy food as if healthy food were a drug. Geisinger assumed that trial participants would eat the healthy food  if Geisinger gave it away for free. Geisinger also teaches program participants about managing their diabetes.The study participants are expected to attend 15 hours of group classes. They have access to a care team, who can help with medication management, nutrition counseling and more.

Geisinger spends $2,400 per year on each patient over 18 months. And, to date, it has seen extraordinary results. Participants’ hemoglobin levels dropped. They experienced a 40 percent reduction in risk of death and complications. And, the annual cost of their care fell $192,000, from $240,000 to $48,000.

The study is small, so a lot is still unknown. Is the healthy food the driver of the program’s success, the patient education, or the synergy between them?  One thing is sure, according to the researchers: “If a new diabetes drug became available that could double the effectiveness of glucose control, it would likely be priced considerably higher than $6 per week (and if it wasn’t, the pharmaceutical firm’s stockholders would be in revolt).“

Learn more about Medicare’s diabetes prevention program.

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