Produce Prescription Subsidy for Patients With Diabetes: A Pragmatic Randomized Clinical Trial

Top Things to Know

Produce subsidies alone may be insufficient to improve diabetes outcomes (additional supports like coaching, nutrition education, or care coordination are important).

These results highlight that FIM programs must address enrollment barriers, usability, and behavioral support (not just provide funds).

Successful FIM programs likely need to comprehensive to include integrating counseling support, culturally tailored nutrition education, as well as the medically tailored food.

Summary of Conclusion/Findings

This large, pragmatic randomized clinical trial evaluated a year‑long produce prescription (PRx) subsidy—$80 per month—for more than 2,100 adults with type 2 diabetes who were at risk for food insecurity. The study found no clinically meaningful improvements in cardiometabolic outcomes: HbA1c levels did not improve in the PRx arm, and the usual care group actually showed a small but statistically significant reduction in HbA1c over 12 months. There were also no significant differences between the PRx and usual‑care groups in emergency department visits, body mass index, blood pressure, or inpatient utilization. Benefit use varied substantially—21% of participants never used the subsidy, and only 30% consistently used 80% or more of the benefit—suggesting engagement challenges. Subgroup analyses of participants with HbA1c ≥8% showed similarly null findings, again favoring usual care. Overall, the study concludes that a produce subsidy alone did not improve clinical outcomes among food‑insecure patients with diabetes.