FIM is being used to address a range of diet-sensitive conditions. To make FIM integration more tangible, this toolkit focuses on patients with type 2 diabetes (diabetes).

Diabetes is one of the most common and costly chronic diseases in the US. Diet plays a central role in both the development and management of diabetes. In the US, 70% of new diabetes cases are estimated to result from poor nutrition. The main drivers are insufficient consumption of specific healthy foods (i.e., fruits, vegetables, beans, nuts, whole grains, plant oils, seafood, and yogurt) and excess consumption of harmful foods (i.e., refined grains, added sugars, and processed meats).

Because food is so central to diabetes onset, management, and outcomes, FIM interventions provide a natural focus for positive impact. Among individuals with diabetes, nutrition can help reduce a range of costly downstream complications, including kidney and eye disease and risk of heart disease and stroke. Thus, FIM programs can align dietary therapy with medical needs, ensuring patients have access to healthy foods together with guidance and education to achieve sustainable healthful eating.

Impact of FIM on Diabetes Outcomes

A range of studies show that FIM interventions improve outcomes for adults with type 2 diabetes while reducing hospital utilization and health care costs.

• Medically Tailored Meals (MTMs) show the strongest and most consistent utilization and cost impacts for high-risk patients, including fewer hospital and skilled-nursing admissions with site-level savings.

• Medically Tailored Groceries (MTGs) and Produce Prescriptions (PRx) produce modest but clinically relevant reductions in HbA1c and blood pressure over several months, and possibly BMI. Effects may be larger when baseline levels are higher. Modeling studies suggest high cost-effectiveness or even modest cost-savings at scale.

• Nutrition Counseling (MNT) helps patients gain tangible skills and behavior change strategies. MNT has been shown to reduce HbA1c, blood pressure, lipids, and body weight.

• FIM interventions also improve patient-centered outcomes like mental stress and food insecurity, factors that have been associated with worse diabetes outcomes and higher costs of care.

As with other medical therapies, FIM treatments should be tailored to address each patient’s needs based on their disease state and other health, social, and life circumstances.