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Woman in green dress with white apron and man in blue shirt prepare a nutritious meal with vegetables, fruit and eggs in a well-lit kitchen.

CREW: Carbohydrate Reduction Empowering Wellness (formerly Therapeutic Carbohydrate Reduction (TCR) Aspire)

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Veterans with suboptimal cardiometabolic health face numerous challenges when trying to lose weight and control blood sugar and blood pressure. CREW is a 16-week group program that uses weekly goal setting and whole health coaching to support Veterans with Type 2 Diabetes and other metabolic health conditions. Veterans in CREW work to modify habits related to comprehensive lifestyle behaviors resulting in improved cardiometabolic health markers, weight loss, and deprescribing of medications. CREW uses a stop light approach to nutrition that allows Veterans to reduce their carbohydrate intake gradually and safely, while working with a pharmacist as needed to quickly adjust medications related to hypoglycemia and hypotension. CREW is a patient centered approach to controlling and reversing type two diabetes, insulin resistance, obesity, and other cardiometabolic chronic illness.

This innovation is emerging and worth watching as it is being assessed in early implementations. See more emerging innovations.


1 successful, 1 in-progress

Awards and Recognition:

VHA Shark Tank Winner


Patient Centered Care and Cultural Transformation



  • Cardiometabolic Laboratory Outcomes Cohort 1 (see image below)
  • Average Weight Loss Cohort 1 (see image below)
  • Medication Interventions Cohort 1 (see image below)

Diffusion tracker

Does not include Clinical Resource Hubs (CRH)


FL: Orlando VA Medical Center (Orlando)
  • Started adoption on 06/2024.

There are no unsuccessful adoptions for this innovation.




Change in Cardiometabolic Laboratory Values from Baseline to Post-Program By PharmD Kaitlyn Quinn


Average Weight Loss from Baseline to Week 16 by PharmD Kaitlyn Quinn


Pertinent Medication Interventions Implement During the TCR Aspire Program by CPP Kaitlyn Quinn