Abstract
Diabetes-specific formulas are an effective alternative for providing nutrients and maintaining glycemic control. This study assesses the effect of treatment with an oral enteral nutrition with a hypercaloric diabetes-specific formula (HDSF) for one year, on health-care resources use, health-care costs, glucose control and nutritional status, in 93 type-2 diabetes mellitus (T2DM) malnourished patients. Changes in health-care resources use and health-care costs were collected the year before and during the year of intervention. Glucose status and nutritional laboratory parameters were analyzed at baseline and one-year after the administration of HDSF. The administration of HDSF was significantly associated with a reduced use of health-care resources, fewer hospital admissions (54.7%; p < 0.001), days spent at hospital (64.1%; p < 0.001) and emergency visits (57.7%; p < 0.001). Health-care costs were reduced by 65.6% (p < 0.001) during the intervention. Glycemic control (short- and long-term) and the need of pharmacological treatment did not change, while some nutritional parameters were improved at one year (albumin: +10.6%, p < 0.001; hemoglobin: +6.4%, p = 0.026). In conclusion, using HDSF in malnourished older type-2 diabetic patients may allow increasing energy intake while maintaining glucose control and improving nutritional parameters. The use of health-care resources and costs were significantly reduced during the nutritional intervention.
Highlights
Diabetes mellitus (DM) is a major health problem due to its prevalence, mortality and cost.The International Diabetes Federation estimated in 2014 its global prevalence at 8.3% [1]
The objective of this study is to assess the effect of enteral supplementation with the hypercaloric diabetes-specific formula (HDSF) Glucerna® 1.5 Cal, from Abbott Nutrition, on the use of health-care resources, health-care costs, glucose control and nutritional status in type-2 diabetes mellitus (T2DM) older malnourished patients in a real life setting
All patients diagnosed with T2DM plus protein-caloric malnutrition living in the community who were started on an oral nutritional supplement between 2011 and 2013 in our outpatient clinics and had at least one follow up visit after completion of treatment were included
Summary
Diabetes mellitus (DM) is a major health problem due to its prevalence, mortality and cost. The International Diabetes Federation estimated in 2014 its global prevalence at 8.3% [1]. It imposes a large and growing economic burden on the health-care system and society [2,3,4] due to the increase in the number of people with diagnosed diabetes, the increased frequency of chronic complications and the wider application of new and expensive technologies and treatments [5]. Disease-related malnutrition is common in diabetic patients [6]. Hospital related malnutrition is associated with treatment intolerance, poor prognosis, increased hospital-acquired infections, poor wound healing and longer hospitalizations [8]
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