Department of Internal Medicine "A", Yoseftal Hospital, Yotam Road, Eilat 88000, Israel.
Departments of Internal Medicine "E", Wolfson Medical Center, Holon 58100, Israel.
Nutrients. 2019 Aug 8;11(8):1832. doi: 10.3390/nu11081832.
We studied the effect of the addition of an oral nutrition supplement (ONS) on the rate of hypoglyemia among hospitalized type 2 diabetes mellitus (DM) patients.
In this retrospective analysis, all DM patients with hypoalbuminemia (albumin < 3.5 g/dL) admitted to internal medicine "E" at Wolfson Medical Center between 1 June 2016 and 30 April 2017 were included. One bottle of ONS (Glucerna, 330 KCAL, 28 g carbohydrates, 17 g protein, 17 g fat) was added to the morning meal. The consumption of the ONS was verified during the morning rounds. All glucose measurements were recorded automatically in the patients' electronic medical records. A logistic regression model was used to evaluate the effect of the nutrition support on the occurrence of hypoglycemia.
218 patients (mean age 77.4 ± 12.0 years, 63.3% female, mean albumin 3.13 ± 0.32 g/dL), of whom 27.9% had documented hypoglycemia during hospitalization were included. The patients consumed 69.5% ± 37.1 of the ONS provided, and ONS was started 4.3 ± 5.3 days from admission. A logistic regression model indicated that age (Odds ratio [OR] 1.048, 95% CI 1.014-1.083, = 0.005), insulin treatment (OR 3.059, 95% CI 1.497-6.251, = 0.002), and the day of ONS started from admission (OR 1.094, 95% CI 1.021-1.173, = 0.011) were associated with an increased risk of hypoglycemia. Complete consumption of the ONS was associated with a reduced risk of hypoglycemia: OR 0.364, 95% CI 0.149-0.890, = 0.027. Age, other DM medications and serum albumin did not affect the risk.
The intake of a complete serving of ONS may be associated with a reduction of the risk of hypoglycemia among diabetes in-patients with hypoalbuminemia.
我们研究了添加口服营养补充剂（ONS）对住院 2 型糖尿病（DM）患者低血糖发生率的影响。
在这项回顾性分析中，纳入了 2016 年 6 月 1 日至 2017 年 4 月 30 日期间在 Wolfson 医疗中心内科“E”病房住院的低白蛋白血症（白蛋白 < 3.5 g/dL）的所有 DM 患者。在早餐时添加一瓶 ONS（Glucerna，330 千卡，28 克碳水化合物，17 克蛋白质，17 克脂肪）。ONS 的摄入量在晨间查房时进行验证。所有血糖测量均自动记录在患者的电子病历中。使用逻辑回归模型评估营养支持对低血糖发生的影响。
共纳入 218 例患者（平均年龄 77.4 ± 12.0 岁，63.3%为女性，平均白蛋白 3.13 ± 0.32 g/dL），其中 27.9%在住院期间发生了低血糖。患者ONS 的摄入量为 69.5% ± 37.1%，ONS 从入院起第 4.3 ± 5.3 天开始使用。逻辑回归模型表明，年龄（优势比 [OR] 1.048，95%置信区间 [CI] 1.014-1.083， = 0.005）、胰岛素治疗（OR 3.059，95%CI 1.497-6.251， = 0.002）和ONS 开始使用的天数（OR 1.094，95%CI 1.021-1.173， = 0.011）与低血糖风险增加相关。完全摄入 ONS 与低血糖风险降低相关：OR 0.364，95%CI 0.149-0.890， = 0.027。年龄、其他 DM 药物和血清白蛋白并未影响风险。
对于低白蛋白血症的住院糖尿病患者，摄入完整剂量的 ONS 可能与降低低血糖风险相关。
