Enhancing diabetes self-management and reducing stress through food skills education with medically under-insured individuals with type-2 diabetes

Top Things to Know

Teaching patients how to plan, shop, and cook healthy meals significantly improved diet quality and reduced stress.

The combination of produce access with coaching and group education led to measurable improvements in blood pressure and self-management.

Improved confidence in managing food and diabetes correlated with lower perceived stress, a key barrier to glycemic control.

Summary of Conclusion/Findings

The Fresh Start Food Is Medicine (FIM) intervention was a 20-week program targeting medically underinsured adults with type-2 diabetes in rural North Carolina. It combined produce prescriptions, group culinary and lifestyle classes, and individualized health coaching to build food skills and support diabetes self-management. Participants showed statistically significant improvements in food skills confidence, diet quality (fruit, vegetable, and whole grain intake), diabetes self-management, and perceived stress. Systolic and diastolic blood pressure also declined significantly, while HbA1c and weight showed modest, non-significant improvements. Regression analysis revealed that increases in food skills and diabetes self-management were significant predictors of reduced stress. The study highlights the value of integrating food literacy and behavioral support into FIM programs to improve both psychosocial and clinical outcomes in underserved populations.