title: Health-Care Costs, Glycemic Control and Nutritional Status in Malnourished Older Diabetics Treated with a Hypercaloric Diabetes-Specific Enteral Nutritional Formula.
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.
authors.affiliation: Nutrition Unit, Universitary Hospital Miguel Servet, Isabel the Catholic 1-3, Zaragoza 50009, Spain. asanzp@salud.aragon.es.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Sanz-Paris
authors.affiliation: Nutrition Unit, Universitary Hospital Miguel Servet, Isabel the Catholic 1-3, Zaragoza 50009, Spain. dianna_bc@hotmail.com.
authors.forename: Diana
authors.initials: D
authors.lastname: Boj-Carceller
authors.affiliation: Nutrition Unit, Universitary Hospital Miguel Servet, Isabel the Catholic 1-3, Zaragoza 50009, Spain. bealardies@gmail.com.
authors.forename: Beatriz
authors.initials: B
authors.lastname: Lardies-Sanchez
authors.affiliation: Nutrition Unit, Universitary Hospital Miguel Servet, Isabel the Catholic 1-3, Zaragoza 50009, Spain. leticca@hotmail.com.
authors.forename: Leticia
authors.initials: L
authors.lastname: Perez-Fernandez
authors.affiliation: Geriatric Department, Universitary Hospital Ramón y Cajal, Ramón y Cajal de Sanitary Investigation  Institution (IRYCIS), Madrid 28034, Spain. ajcruzjentoft@telefonica.net.
authors.forename: Alfonso J
authors.initials: AJ
authors.lastname: Cruz-Jentoft
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism*; D017046:Cost Savings; D003362:Cost-Benefit Analysis; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000178:diet therapy* / Q000191:economics / Q000503:physiopathology; D003927:Diet, Diabetic / Q000009:adverse effects / Q000191:economics; D004636:Emergency Service, Hospital; D002149:Energy Intake; D004750:Enteral Nutrition / Q000009:adverse effects / Q000191:economics; D005260:Female; D005526:Food, Formulated / Q000009:adverse effects / Q000191:economics; D006442:Glycated Hemoglobin / Q000378:metabolism; D006295:Health Resources / Q000191:economics* / Q000706:statistics & numerical data; D017721:Hospital Costs; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007902:Length of Stay / Q000191:economics; D008297:Male; D044342:Malnutrition / Q000097:blood / Q000178:diet therapy* / Q000191:economics / Q000503:physiopathology; D015596:Nutrition Assessment; D009752:Nutritional Status; D010343:Patient Admission / Q000191:economics; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; C517652:hemoglobin A1c protein, human
keywords: diabetes enteral formula; diabetes mellitus; heath care cost; malnutrition