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BAI Q, XU J, ZHU W, HUANG C, NI X, ZHAO H, FENG X, LI L, DU S, FAN R, WANG J. Effects of consumption of a low glycaemic index formula on glycaemic control in patients with type 2 diabetes managed by medical nutrition therapy. FOOD SCIENCE AND TECHNOLOGY 2021. [DOI: 10.1590/fst.51320] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
| | - Jing XU
- Army Medical University, China
| | | | | | | | | | | | - Li LI
- Army Medical University, China
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Holmes JL, Biella A, Morck T, Rostorfer J, Schneeman B. Medical Foods: Science, Regulation, and Practical Aspects. Summary of a Workshop. Curr Dev Nutr 2021; 5:nzaa172. [PMID: 33409445 PMCID: PMC7775186 DOI: 10.1093/cdn/nzaa172] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 10/30/2020] [Accepted: 11/19/2020] [Indexed: 01/03/2023] Open
Abstract
On August 13-14, 2019, the Healthcare Nutrition Council and the ASN held the Medical Foods Workshop: Science, Regulation, and Practical Aspects. Medical food products help patients manage their disease and improve their quality of life. Yet many hurdles exist to getting patients new products. In this workshop, participants addressed some of these hurdles, with specific emphasis on topics like the statutory term distinctive nutritional requirements, the regulatory term modification of the diet alone, the role of clinical guidelines, the requirement that medical foods be used under medical supervision, and differentiation of foods for special dietary use from medical foods, as well as product innovation and future research. Real-world examples were discussed for intractable epilepsy, diabetes, end-stage renal disease, and inflammatory bowel disease.
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Affiliation(s)
| | - Alexandre Biella
- Regulatory Affairs US, Nestlé Health Science, Bridgewater, NJ, USA
| | | | - Jena Rostorfer
- Regulatory Affairs, Abbott Laboratories, Columbus, OH, USA
| | - Barbara Schneeman
- Department of Nutrition, University of California, Davis, Davis, CA, USA
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Matia Martin P, Robles Agudo F, Lopez Medina JA, Sanz Paris A, Tarazona Santabalbina F, Domenech Pascual JR, Lopez Penabad L, Sanz Barriuso R. Effectiveness of an oral diabetes-specific supplement on nutritional status, metabolic control, quality or life, and functional status in elderly patients. A multicentre study. Clin Nutr 2019; 38:1253-1261. [DOI: 10.1016/j.clnu.2018.05.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Revised: 03/13/2018] [Accepted: 05/04/2018] [Indexed: 12/20/2022]
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Salas-Zapata L, Palacio-Mejía LS, Aracena-Genao B, Hernández-Ávila JE, Nieto-López ES. Costos directos de las hospitalizaciones por diabetes mellitus en el Instituto Mexicano del Seguro Social. GACETA SANITARIA 2018; 32:209-215. [PMID: 27495830 DOI: 10.1016/j.gaceta.2016.06.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2016] [Revised: 06/04/2016] [Accepted: 06/14/2016] [Indexed: 11/25/2022]
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Abstract
Medical nutrition therapy (MNT) is a key component of diabetes management. The importance of balancing macronutrients, reducing carbohydrate load, lowering glycemic index, and implementing an overall healthy dietary pattern are emerging as better approaches for MNT in diabetes. Recent research points to improved glycemic control, reduction in body weight, and improvement in many cardiovascular risk factors when these approaches are provided by registered dietitians or health care providers. This review article discusses the current evidence about the role of sensible nutrition in diabetes management. Specific eating plans for weight reduction and for patients with type 1 diabetes are also discussed.
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Affiliation(s)
- Osama Hamdy
- Department of Endocrinology, Joslin Diabetes Center, Harvard Medical School, One Joslin Place, Boston, MA 02481, USA.
| | - Mohd-Yusof Barakatun-Nisak
- Joslin Diabetes Center, Harvard Medical School, Boston, MA 02215, USA; Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor 43400, Malaysia
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Affiliation(s)
- Arlene A. Escuro
- Center for Human Nutrition, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - A. Christine Hummell
- Center for Human Nutrition, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, Ohio, USA
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Health-Care Costs, Glycemic Control and Nutritional Status in Malnourished Older Diabetics Treated with a Hypercaloric Diabetes-Specific Enteral Nutritional Formula. Nutrients 2016; 8:153. [PMID: 27005661 PMCID: PMC4808881 DOI: 10.3390/nu8030153] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Revised: 02/17/2016] [Accepted: 02/29/2016] [Indexed: 12/16/2022] Open
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.
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Correia MI, Hegazi RA, Diaz-Pizarro Graf JI, Gomez-Morales G, Fuentes Gutiérrez C, Goldin MF, Navas A, Pinzón Espitia OL, Tavares GM. Addressing Disease-Related Malnutrition in Healthcare: A Latin American Perspective. JPEN J Parenter Enteral Nutr 2016; 40:319-25. [PMID: 25883116 PMCID: PMC4767145 DOI: 10.1177/0148607115581373] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Accepted: 02/10/2015] [Indexed: 01/04/2023]
Abstract
Alarmingly high rates of disease-related malnutrition have persisted in hospitals of both emerging and industrialized nations over the past 2 decades, despite marked advances in medical care over this same interval. In Latin American hospitals, the numbers are particularly striking; disease-related malnutrition has been reported in nearly 50% of adult patients in Argentina, Brazil, Chile, Costa Rica, Cuba, Dominican Republic, Ecuador, Mexico, Panama, Paraguay, Peru, Puerto Rico, Venezuela, and Uruguay. The tolls of disease-related malnutrition are high in both human and financial terms-increased infectious complications, higher incidence of pressure ulcers, longer hospital stays, more frequent readmissions, greater costs of care, and increased risk of death. In an effort to draw attention to malnutrition in Latin American healthcare, a feedM.E. Latin American Study Group was formed to extend the reach and support the educational efforts of the feedM.E. Global Study Group. In this article, the feedM.E. Latin American Study Group shows that malnutrition incurs excessive costs to the healthcare systems, and the study group also presents evidence of how appropriate nutrition care can improve patients' clinical outcomes and lower healthcare costs. To achieve the benefits of nutrition for health throughout Latin America, the article presents feedM.E.'s simple and effective Nutrition Care Pathway in English and Spanish as a way to facilitate its use.
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Lansink M, Hofman Z, Genovese S, Rouws CHFC, Ceriello A. Improved Glucose Profile in Patients With Type 2 Diabetes With a New, High-Protein, Diabetes-Specific Tube Feed During 4 Hours of Continuous Feeding. JPEN J Parenter Enteral Nutr 2016; 41:968-975. [PMID: 26826263 DOI: 10.1177/0148607115625635] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Hyperglycemia frequently occurs in hospitalized patients receiving nutrition support. In this study, the effects of a new diabetes-specific formula (DSF) on glucose profile during 4 hours of continuous feeding and 4 hours after stopping feeding were compared with a standard formula (SF). MATERIALS AND METHODS In this randomized, controlled, double-blind, crossover study, ambulant, nonhospitalized patients with type 2 diabetes received the DSF or an isocaloric, fiber-containing SF via a nasogastric tube. After overnight fasting, the formula was continuously administered to the patients during 4 hours. Plasma glucose and insulin concentrations were determined during the 4-hour period and in the subsequent 4 hours during which no formula was provided. RESULTS During the 4-hour feeding period, DSF compared with SF resulted in a lower mean delta glucose concentration in the 3- to 4-hour period (0.3 ± 1.0 and 2.4 ± 1.5 mmol/L; P < .001). Also, the (delta) peak concentrations, (delta) mean concentrations, and incremental area under the curve (iAUC) for glucose and insulin were significantly lower during DSF compared with SF feeding (all comparisons: P < .001). Furthermore, fewer patients experienced hyperglycemia (>10 mmol/L) on DSF compared with SF (2 vs 11, P = .003, respectively). No differences in number of patients with hypoglycemia (<3.9 mmol/L) were observed. No significant differences in tolerance were observed. CONCLUSION Administration of a new, high-protein DSF during 4 hours of continuous feeding resulted in lower glucose and insulin levels compared with a fiber-containing SF in ambulant, nonhospitalized patients with type 2 diabetes. These data suggest that a DSF may contribute to lower glucose levels in these patients.
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Affiliation(s)
- Mirian Lansink
- 1 Nutricia Research, Nutricia Advanced Medical Nutrition, Utrecht, the Netherlands
| | - Zandrie Hofman
- 1 Nutricia Research, Nutricia Advanced Medical Nutrition, Utrecht, the Netherlands
| | - Stefano Genovese
- 2 Department of Cardiovascular and Metabolic Diseases, IRCCS Gruppo Multimedica, Sesto San Giovanni (MI), Italy
| | - Carlette H F C Rouws
- 1 Nutricia Research, Nutricia Advanced Medical Nutrition, Utrecht, the Netherlands
| | - Antonio Ceriello
- 3 Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,4 Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain
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Wen T, Attenello FJ, Wu B, Ng A, Cen SY, Mack WJ. The july effect: an analysis of never events in the nationwide inpatient sample. J Hosp Med 2015; 10:432-8. [PMID: 25828426 DOI: 10.1002/jhm.2352] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Revised: 03/02/2015] [Accepted: 03/03/2015] [Indexed: 11/08/2022]
Abstract
BACKGROUND Prior studies examining the impact of the "July effect" on in-hospital mortality rates have generated variable results. In 2008, the Centers for Medicare & Medicaid Services published a series of high-cost, high-volume, nonreimbursable hospital-acquired complications (HACs). These events were believed to be preventable and indicate deficiencies in healthcare delivery. OBJECTIVE The present study aims to investigate the impact of July admissions on patient safety in a national sample using the HACs as a metric. DESIGN/SETTING/PATIENTS Discharge data were collected from all admissions recorded in the Nationwide Inpatient Sample database from 2008 to 2011. HAC incidence was evaluated as a function of admission month, adjusting for demographic and hospital factors in multivariable analysis. MEASURES The outcome measures were HAC occurrence, prolonged length of stay (LOS), and higher inpatient costs. RESULTS A total of 143,019,381 inpatient admissions were recorded, with an overall HAC occurrence of 4.7%. July admissions accounted for 7.6% of the total number of inpatient admissions. July admissions experienced a 6% increase in likelihood of HAC occurrence (odds ratio = 1.06, 95% confidence interval: 1.06-1.07, P < 0.001) when compared to those admitted during all other months. Patients with HAC occurrence had almost 2 times increased likelihood of prolonged LOS (P < 0.001) and higher inpatient costs (P < 0.001). CONCLUSIONS July admissions are associated with increased likelihood of HAC occurrence. This trend may represent breakdowns in organization structure distinct from traditional quality measures, requiring novel transition protocols dedicated to improving HACs.
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Affiliation(s)
- Timothy Wen
- Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Frank J Attenello
- Department of Neurosurgery, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Brian Wu
- Department of Integrative Biology of Disease, Keck School of Medicine, University of Southern California, Los Angeles
| | - Alvin Ng
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Steven Y Cen
- Department of Neurosurgery, Keck School of Medicine, University of Southern California, Los Angeles, California
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
- Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, California
- Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - William J Mack
- Department of Neurosurgery, Keck School of Medicine, University of Southern California, Los Angeles, California
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Philipson T, Linthicum MT, Snider JT. Tutorial on health economics and outcomes research in nutrition. JPEN J Parenter Enteral Nutr 2014; 38:5S-16S. [PMID: 25239114 DOI: 10.1177/0148607114549770] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
As healthcare costs climb around the world, public and private payers alike are demanding evidence of a treatment's value to support approval and reimbursement decisions. Health economics and outcomes research, or HEOR, offers tools to answer questions about a treatment's value, as well as its real-world effects and cost-effectiveness. Given that nutrition interventions have to compete for space in budgets along with biopharmaceutical products and devices, nutrition is now increasingly coming to be evaluated through HEOR. This tutorial introduces the discipline of HEOR and motivates its relevance for nutrition. We first define HEOR and explain its role and relevance in relation to randomized controlled trials. Common HEOR study types--including burden of illness, effectiveness studies, cost-effectiveness analysis, and valuation studies--are presented, with applications to nutrition. Tips for critically reading HEOR studies are provided, along with suggestions on how to use HEOR to improve patient care. Directions for future research are discussed.
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Affiliation(s)
- Tomas Philipson
- Irving B. Harris School of Public Policy Studies, The University of Chicago, Chicago, Illinois
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