Outcomes of Cooking Matters for Diabetes: A 6-week Randomized, Controlled Cooking and Diabetes Self-Management Education Intervention

Published:August 09, 2022DOI:



      Diabetes self-management education and support is the cornerstone of diabetes care, yet only 1 in 2 adults with diabetes attain hemoglobin A1c (HbA1c) targets. Food insecurity makes diabetes management and HbA1c control more difficult.


      Our aim was to test whether a cooking intervention with food provision and diabetes self-management education and support improves HbA1c and diabetes management.


      This was a waitlist-controlled, randomized trial.


      Participants were 48 adults with type 1 or type 2 diabetes.


      Cooking Matters for Diabetes was adapted from Cooking Matters and the American Diabetes Association diabetes self-management education and support intervention into a 6-week program with weekly food provision (4 servings).

      Main outcome measures

      Surveys (ie, Summary of Diabetes Self-Care Activities; Medical Outcomes Study Short Form Health Survey, version 1; Diet History Questionnaire III; 10-item US Adult Food Security Survey Module; and Stanford Diabetes Self-Efficacy Scale) were administered and HbA1c was measured at baseline, post intervention, and 3-month follow-up.

      Statistical analysis

      Mixed-effects linear regression models controlling for sex and study wave were used.


      Mean (SD) age of participants was 57 (12) years; 65% identified as female, 52% identified as White, 40% identified as Black, and 19 (40%) were food insecure at baseline. Intervention participants improved Summary of Diabetes Self-Care Activities general diet score (0 to 7 scale) immediately post intervention (+1.51; P = .015) and 3 months post intervention (+1.23; P = .05), and improved Medical Outcomes Study Short Form Health Survey, version 1, mental component score (+6.7 points; P = .025) compared with controls. Healthy Eating Index 2015 total vegetable component score improved at 3 months (+0.917; P = .023) compared with controls. At baseline, food insecure participants had lower self-efficacy (5.6 vs 6.9 Stanford Diabetes Self-Efficacy Scale; P = .002) and higher HbA1c (+0.77; P = .025), and demonstrated greater improvements in both post intervention (+1.2 vs +0.4 Stanford Diabetes Self-Efficacy Scale score; P = .002, and –0.12 vs +0.39 HbA1c; P = .25) compared with food secure participants.


      Cooking Matters for Diabetes may be an effective method of improving diet-related self-care and health-related quality of life, especially among food insecure patients, and should be tested in larger randomized controlled trials.


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      A. Williams is a postdoctoral scholar, Division of Endocrinology, Diabetes and Metabolism, The Ohio State University College of Medicine, Columbus.


      J. C. Shrodes is a certified diabetes care and education specialist and staff dietitian, Division of Endocrinology, Diabetes and Metabolism, The Ohio State University College of Medicine, Columbus.


      J. N. Radabaugh is a graduate student, Division of Medical Dietetics, The Ohio State University College of Medicine, Columbus.


      A. Braun is an assistant professor, Department of Nutritional Sciences, School of Education and Human Sciences, Oklahoma State University, Stillwater; at the time of the study she was a postdoctoral scholar, Division of Medical Dietetics, The Ohio State University College of Medicine, Columbus.


      D. Kline is an assistant professor, Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC.


      S. Zhao is a biostatistician, Center for Biostatistics, The Ohio State University College of Medicine, Columbus.


      G. Brock is an associate professor, Department of Biomedical Informatics, The Ohio State University College of Medicine, Columbus.


      T. S. Nolan is an assistant professor, The Ohio State University College of Nursing, Columbus.


      J. A. Garner is an assistant professor, The School of Health and Rehabilitation Sciences, The Ohio State University College of Medicine and The John Glenn College of Public Affairs, The Ohio State University, Columbus.


      C. K. Spees is an associate professor, Division of Medical Dietetics, The Ohio State University College of Medicine, Columbus.


      J. J. Joseph is an assistant professor, The Ohio State University College of Medicine, Columbus.

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