The clinical and economic impact of the use of diabetes-specific enteral formula on ICU patients with type 2 diabetes
Journal
Clinical Nutrition
Journal Volume
36
Journal Issue
6
Pages
1567-1572
Date Issued
2017
Author(s)
Abstract
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. ? 2016 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism
SDGs
Other Subjects
insulin; age; aged; Article; body mass; body weight; comorbidity; controlled study; critically ill patient; enteric feeding; female; gender; health care cost; health economics; hospitalization; human; insulin treatment; intensive care unit; length of stay; major clinical study; male; medical record; medication therapy management; mortality; non insulin dependent diabetes mellitus; outcome assessment; prescription; retrospective study; Taiwan; university hospital; adult; blood; critical illness; economics; enteric feeding; follow up; intensive care unit; middle aged; non insulin dependent diabetes mellitus; sensitivity and specificity; treatment outcome; very elderly; young adult; Adult; Aged; Aged, 80 and over; Body Mass Index; Critical Illness; Diabetes Mellitus, Type 2; Enteral Nutrition; Female; Follow-Up Studies; Humans; Insulin; Intensive Care Units; Length of Stay; Male; Medical Records; Middle Aged; Retrospective Studies; Sensitivity and Specificity; Taiwan; Treatment Outcome; Young Adult
Type
journal article