Effectiveness of an oral diabetes-specific supplement on nutritional status, metabolic control, quality or life, and functional status in elderly patients. A multicentre study

Autor: Matia Martin P, Robles Agudo F, Lopez Medina J, Sanz Paris A, Tarazona Santabalbina F, Domenech Pascual J, Lopez Penabad L, Sanz Barriuso R
Rok vydání: 2019
Předmět:
Zdroj: CLINICAL NUTRITION
r-FISABIO. Repositorio Institucional de Producción Científica
instname
ISSN: 0261-5614
Popis: Background & aims: The purpose of this study was to assess nutritional status, quality of life (QoL) and function in malnourished or at risk for malnutrition community-dwelling (CD) and nursing home dwelling (NHD) elderly patients with type 2 diabetes mellitus (DM2), receiving treatment with a diabetes-specific oral nutritional supplement (DSONS). Methods: A prospective, multicentre, observational study was conducted. A DSONS (high-calorie, high protein, with slow-digestible carbohydrate and high monounsaturated fatty acid - MUFA - content Glucerna (R) 1.5 Cal) had been prescribed the week before inclusion. The following assessments were undertaken at baseline (BL), at week 6 (V1) and at month 3 (FV): body mass index (BMI), glycosylated haemoglobin (HbA(1c)), nutritional status (Mini Nutritional Assessment - MNA), QoL (EQ-5D questionnaire), and functional status (Katz Index - KI of Independence in Activities of Daily Living). The data were reported in the overall population (OP) and in the CD and NHD groups. Results: A total of 402 patients aged 80.8 +/- 8.5 years were evaluable (44.5% men), including 61.7% CD and 38.3% NHD. BMI (kg/m(2)) increased in the OP from 22.0 +/- 3.5 at BL to 22.5 +/- 3.6 at V1 (p < 0.001) and 23.0 +/- 3.7 at the FV (p < 0.001). BMI also increased in the CD group (p < 0.001) and in the NHD group (p < 0.001). HbA(1c) decreased in the OP from 7.3 +/- 1.1% at BL to 7.2 +/- 1.0% at V1 and 7.0 +/- 0.9% at the FV (p < 0.001), in both the CD (p < 0.001) and the NHD groups (p = 0.020). The mean overall MNA score increased in the OP from 13.1 +/- 4.8 at BL to 17.0 +/- 4.7 at V1 and 18.6 +/- 5.1 at the FV (p < 0.001). The mean overall MNA score also increased in the CD (p < 0.001) and the NHD groups (p < 0.001). The mean overall EQ-5D score improved in the OP from 46.0 +/- 18.0 at BL to 54.8 +/- 17.5 at V1 and 59.7 +/- 18.8 at the FV (p < 0.001). The mean overall EQ-5D score also improved in the CD (p < 0.001) and the NHD groups (p < 0.001). Gastrointestinal adverse events were seen in only 2% of patients. Treatment compliance was 94.4%. Conclusions: In this study, conducted in routine, multicentre, clinical settings, the treatment with the high-calorie, high-protein, with slow-digestible carbohydrate, and high MUFA content DSNOS - Glucerna (R) 1.5 Cal-, was associated with improvements in HbA(1c), nutritional status, BMI and QoL following 6 weeks and 3 months of treatment in both institutionalised and non-institutionalised elderly patients with diabetes who were malnourished or at risk for malnutrition. A slight improvement in functional status was also observed at 12 weeks. As this is an observational effectiveness study, a randomized controlled trial would be necessary to establish a causal relationship between the DSNOS and the described events. (c) 2018 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.
Databáze: OpenAIRE
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