The clinical and economic impact of the use of diabetes-specific enteral formula on ICU patients with type 2 diabetes. Issue 6 (December 2017)

• Record Type: Journal Article
• Authors: Han, Yin-Yi; Lai, Sheng-Ru; Partridge, Jamie S.; Wang, Michael Y.; Sulo, Suela; Tsao, Fang-Wei; Hegazi, Refaat A.
• Is Part Of: Clinical nutrition. Volume 36:Issue 6(2017:Dec.)
• Page Start: 1567
• Page End: 1572
• Publication Date: 2017-12
• Subjects: Diabetes -- Critical illness -- Enteral nutrition -- Diabetes-specific formulas -- Health economics; ICU intensive care unit -- EN enteral nutrition -- T2D type 2 diabetes -- DSF diabetes-specific formula -- Non-DSF non-diabetes-specific formula -- LOS length of stay -- BMI body mass index -- OHA oral hypoglycemic agent; Critically ill -- Nutrition -- Periodicals; Diet therapy -- Periodicals; Parenteral feeding -- Periodicals; Enteral feeding -- Periodicals; Enteral Nutrition -- Periodicals; Parenteral Nutrition -- Periodicals; Metabolism -- Periodicals; Diétothérapie -- Périodiques; Alimentation parentérale -- Périodiques; Alimentation entérale -- Périodiques; Nutrition -- Périodiques; Diet therapy; Enteral feeding; Nutrition; Parenteral feeding; Electronic journals; Periodicals; Electronic journals; 615.854
• DOI: 10.1016/j.clnu.2016.09.027
• Languages: English
• ISSNs: 0261-5614

Abstract

Summary: Background & aims: Patients admitted to intensive care units (ICUs) often need enteral nutrition (EN) support. For patients with type 2 diabetes (T2D), standard EN formulas may not provide ideal nutrients. The purpose was to investigate whether use of a diabetes-specific formula (DSF) could provide clinical and health economic benefits (compared to standard formulas) in critically ill patients with T2D. Methods: This study was a retrospective analysis of medical records and expenditure data covering a 5-year period (2009–2013) from the hospitalization database of the National Taiwan University Hospital. Records of ICU patients who had T2D and were receiving enteral feeding with either the DSF or non-diabetes-specific formula (non-DSF) for at least 5 days were included in the analysis. Mortality, ICU length of stay (LOS), diabetes-related medications, and total costs of care (including all costs covered by the National Health Insurance and private expenses) were considered as the primary outcomes. Results: A total of 158 patient records were analyzed in the DSF group and 794 in the non-DSF group. The baseline demographics including age, gender, weight, body mass index (BMI), and comorbidity patterns were mostly comparable between the groups. Compared to those receiving non-DSF, patients with T2D receiving DSF were found to have significantly decreased mortality (5.1% vs. 12.3%, P = 0.0118) and reduced need for insulin prescription (29.1% vs. 38.4%, P = 0.0269). ICU LOS was shorter for DSF patients, but no statistical difference was found (13.0 days vs. 15.1 days, P = 0.1843). However, significantly lower total ICU costs were reported for DSF patients (6700 USD vs. 9200 USD, P < 0.0001). Conclusions: The use of DSF in ICU patients with T2D is correlated with significant reduction in mortality and improved health economic outcomes.