Sanz-Paris Alejandro, Boj-Carceller Diana, Lardies-Sanchez Beatriz, Perez-Fernandez Leticia, Cruz-Jentoft Alfonso J
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.
Nutrients. 2016 Mar 9;8(3):153. doi: 10.3390/nu8030153.
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.
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。
