Voucher for Healthy Foods and Diabetes Control: A Randomized Clinical Trial
An erratum to this article was published (JAMA Intern Med, 1 Jul 2026 ↗)
Authors' conclusion
In this randomized clinical trial, a monthly food voucher did not have an effect on HbA1c control or objective measures of diet quality but the voucher did increase self-reported vegetable and fruit consumption.
Study context
- Population
- Patients with diabetes experiencing food insecurity, hemoglobin A1c (HbA1c) 6.0% to 11%, 7 sites in Toronto, Canada; mean (SD) age 60 (13) years, 49% men1,061 approached
- Participants
- 390 patients
- Comparison
- Monthly grocery store voucher for healthy foods vs usual access to healthy foods
- Vouchern = 194
- Controln = 196reference
- Primary endpoint
- Change in HbA1c from baseline
- Follow-up
- 6 months
Methodological detailsparallel-arm, multicentre (7 sites), Conducted March 21, 2023, to April 1, 2025
- Parallel-arm
- Multicentre (7 sites)
- Conducted March 21, 2023, to April 1, 2025
Primary result
As reported in the abstract
Change in HbA1c
Each group vs controlEstimate (95% CI)P value
Voucher
mean difference −0.18 %(−0.41 to 0.05)
P = 0.13Voucher
mean difference adjusted for baseline HbA1c, age, sex, household size, and condition −0.10 %(−0.33 to 0.12)
P = 0.35Secondary outcomes
Self-reported vegetable consumption ≥2 times/day · improved by voucher
Self-reported fruit consumption ≥2 times/day · improved by voucher
| Outcome | Risk difference (95% CI) | |
|---|---|---|
| Food insecurityImproved by voucher | −0.10 (−0.18 to −0.02) | |
| Financial insecurityNot improved by voucher | −0.07 (−0.16 to 0.02) | |
| −0.2−0.100.1Difference (linear scale) |
| Outcome | OR (95% CI) | |
|---|---|---|
| General healthImproved by voucher | 1.6 (1.1–2.3) | |
| 0.512Odds ratio (log scale) |
| Outcome | Mean difference (µmol/L) (95% CI) | |
|---|---|---|
| β-carotene levelNot improved by voucher | 0.01 (−0.08 to 0.06) | |
| Ascorbic acid levelNot improved by voucher | −0.18 (−4.3 to 4.7) | |
| −6−4−20246Difference, µmol/L (linear scale) |
Original publication
Voucher for Healthy Foods and Diabetes Control: A Randomized Clinical Trial. JAMA Intern Med. Published 1 December 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →