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使用高热量糖尿病专用肠内营养配方治疗的营养不良老年糖尿病患者的医疗费用、血糖控制和营养状况

Health-Care Costs, Glycemic Control and Nutritional Status in Malnourished Older Diabetics Treated with a Hypercaloric Diabetes-Specific Enteral Nutritional Formula.

作者信息

Sanz-Paris Alejandro, Boj-Carceller Diana, Lardies-Sanchez Beatriz, Perez-Fernandez Leticia, Cruz-Jentoft Alfonso J

机构信息

Nutrition Unit, Universitary Hospital Miguel Servet, Isabel the Catholic 1-3, Zaragoza 50009, Spain.

Geriatric Department, Universitary Hospital Ramón y Cajal, Ramón y Cajal de Sanitary Investigation  Institution (IRYCIS), Madrid 28034, Spain.

出版信息

Nutrients. 2016 Mar 9;8(3):153. doi: 10.3390/nu8030153.

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.

摘要

糖尿病专用配方是提供营养和维持血糖控制的有效替代方案。本研究评估了93例2型糖尿病(T2DM)营养不良患者使用高热量糖尿病专用配方(HDSF)进行口服肠内营养治疗一年对医疗资源使用、医疗成本、血糖控制和营养状况的影响。在干预前一年和干预期间收集医疗资源使用和医疗成本的变化情况。在基线时以及给予HDSF一年后分析血糖状况和营养实验室参数。给予HDSF与医疗资源使用减少、住院次数减少(54.7%;p<0.001)、住院天数减少(64.1%;p<0.001)和急诊就诊次数减少(57.7%;p<0.001)显著相关。干预期间医疗成本降低了65.6%(p<0.001)。血糖控制(短期和长期)以及药物治疗需求没有变化,而一些营养参数在一年时得到改善(白蛋白:+10.6%,p<0.001;血红蛋白:+6.4%,p=(此处原文有误,应为p = 0.026))。总之,在营养不良的老年2型糖尿病患者中使用HDSF可能在维持血糖控制和改善营养参数的同时增加能量摄入。营养干预期间医疗资源的使用和成本显著降低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ffdc/4808881/b9abfabd53b3/nutrients-08-00153-g001.jpg

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