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Consumption of Nutrition Supplements Is Associated with Less Hypoglycemia during Admission—Results from the MENU Project

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Department of Internal Medicine “A”, Yoseftal Hospital, Yotam Road, Eilat 88000, Israel
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Departments of Internal Medicine “E”, Wolfson Medical Center, Holon 58100, Israel
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Departments of Internal Medicine “F”, Wolfson Medical Center, Holon 58100, Israel
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Department of Nutrition, Wolfson Medical Center, Holon 58100, Israel
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Department of Nutrition Sciences, Ariel University, Ariel 40700, Israel
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Author to whom correspondence should be addressed.
Nutrients 2019, 11(8), 1832; https://doi.org/10.3390/nu11081832
Received: 27 June 2019 / Revised: 30 July 2019 / Accepted: 6 August 2019 / Published: 8 August 2019
Aim: We studied the effect of the addition of an oral nutrition supplement (ONS) on the rate of hypoglyemia among hospitalized type 2 diabetes mellitus (DM) patients. Methods: In this retrospective analysis, all DM patients with hypoalbuminemia (albumin < 3.5 g/dL) admitted to internal medicine “E” at Wolfson Medical Center between 1 June 2016 and 30 April 2017 were included. One bottle of ONS (Glucerna, 330 KCAL, 28 g carbohydrates, 17 g protein, 17 g fat) was added to the morning meal. The consumption of the ONS was verified during the morning rounds. All glucose measurements were recorded automatically in the patients’ electronic medical records. A logistic regression model was used to evaluate the effect of the nutrition support on the occurrence of hypoglycemia. Results: 218 patients (mean age 77.4 ± 12.0 years, 63.3% female, mean albumin 3.13 ± 0.32 g/dL), of whom 27.9% had documented hypoglycemia during hospitalization were included. The patients consumed 69.5% ± 37.1 of the ONS provided, and ONS was started 4.3 ± 5.3 days from admission. A logistic regression model indicated that age (Odds ratio [OR] 1.048, 95% CI 1.014–1.083, p = 0.005), insulin treatment (OR 3.059, 95% CI 1.497–6.251, p = 0.002), and the day of ONS started from admission (OR 1.094, 95% CI 1.021–1.173, p = 0.011) were associated with an increased risk of hypoglycemia. Complete consumption of the ONS was associated with a reduced risk of hypoglycemia: OR 0.364, 95% CI 0.149–0.890, p = 0.027. Age, other DM medications and serum albumin did not affect the risk. Conclusion: The intake of a complete serving of ONS may be associated with a reduction of the risk of hypoglycemia among diabetes in-patients with hypoalbuminemia. View Full-Text
Keywords: albumin; diabetes mellitus; hypoglycemia; oral nutrition supplement albumin; diabetes mellitus; hypoglycemia; oral nutrition supplement
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Leibovitz, E.; Moore, F.; Mintser, I.; Levi, A.; Dubinsky, R.; Boaz, M. Consumption of Nutrition Supplements Is Associated with Less Hypoglycemia during Admission—Results from the MENU Project. Nutrients 2019, 11, 1832.

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