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

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.

Keywords: diabetes enteral formula; diabetes mellitus; heath care cost; malnutrition.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Biomarkers / blood
  • Blood Glucose / metabolism*
  • Cost Savings
  • Cost-Benefit Analysis
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / diet therapy*
  • Diabetes Mellitus, Type 2 / economics
  • Diabetes Mellitus, Type 2 / physiopathology
  • Diet, Diabetic* / adverse effects
  • Diet, Diabetic* / economics
  • Emergency Service, Hospital
  • Energy Intake*
  • Enteral Nutrition* / adverse effects
  • Enteral Nutrition* / economics
  • Female
  • Food, Formulated* / adverse effects
  • Food, Formulated* / economics
  • Glycated Hemoglobin / metabolism
  • Health Resources / economics*
  • Health Resources / statistics & numerical data
  • Hospital Costs
  • Humans
  • Hypoglycemic Agents / therapeutic use
  • Length of Stay / economics
  • Male
  • Malnutrition / blood
  • Malnutrition / diet therapy*
  • Malnutrition / economics
  • Malnutrition / physiopathology
  • Nutrition Assessment
  • Nutritional Status*
  • Patient Admission / economics
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome

Substances

  • Biomarkers
  • Blood Glucose
  • Glycated Hemoglobin A
  • Hypoglycemic Agents
  • hemoglobin A1c protein, human