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.
Sarcopenia and malnutrition are both commonly occurring conditions in elderly population. As understood today, sarcopenia is a syndrome characterised by progressive and generalised loss of skeletal muscle mass, physical performance and/or strength, whereas malnutrition has been deined as a condition of an imbalance of energy, protein and other nutrients that can cause measurable negative efects. In many populations, malnutrition and sarcopenia are present simultaneously, and they appear clinically through a combination of decreased body weight and nutrient intake, along with a decrease in muscle mass and function. Moreover, malnutrition is one of the key pathophysiological causes of sarcopenia. Both entities result in numerous and substantial negative outcomes to the patients and the healthcare system, including decreased quality of life and functionality and increased healthcare costs, hospitalisation rates, morbidity and mortality. Early identiication of sarcopenia would be of great clinical relevance because the loss of muscle mass and strength with ageing can be largely reversed by proper exercise and nutritional intervention. Clinicians should integrate nutritional assessment with sarcopenia screening for optimal evaluation of these two interrelated issues to help improve clinical outcomes.
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