Keller, Bettina; Wunderle, Carla; Tribolet, Pascal; Stanga, Zeno; Kaegi-Braun, Nina; Mueller, Beat; Schuetz, Philipp (2024). Nutritional support in hospitalised patients with diabetes and risk for malnutrition: a secondary analysis of an investigator-initiated, Swiss, randomised controlled multicentre trial. BMJ open, 14(8), e084754. BMJ Publishing Group 10.1136/bmjopen-2024-084754
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OBJECTIVES
The main objective of this study was to investigate the effects of nutritional support on mortality in hospitalised patients with diabetes and nutritional risk participating in the Effect of early nutritional support on Frailty, Functional Outcomes, and Recovery of malnourished medical inpatients Trial (EFFORT) trial.
DESIGN
Secondary analysis of a Swiss-wide multicentre, randomised controlled trial.
PARTICIPANTS
Patients with diabetes and risk for malnutrition.
INTERVENTIONS
Individualised nutritional support versus usual care.
PRIMARY OUTCOME MEASURE
30-day all-cause mortality.
RESULTS
Of the 2028 patients included in the original trial, 445 patients were diagnosed with diabetes and included in this analysis. In terms of efficacy of nutritional therapy, there was a 25% lower risk for mortality in patients with diabetes receiving nutritional support compared with controls (7% vs 10%, adjusted HR 0.75 (95% CI 0.39 to 1.43)), a finding that was not statistically significant but similar to the overall trial effects with no evidence of interaction (p=0.92). Regarding safety of nutritional therapy, there was no increase in diabetes-specific complications associated with nutritional support, particularly there was no increase in risk for hyperglycaemia (adjusted OR 0.97, 95% CI 0.56 to 1.67 p=0.90).
CONCLUSION
Patients with diabetes and malnutrition in the hospital setting have a particularly high risk for adverse outcomes and mortality. Individualised nutritional support reduced mortality in this secondary analysis of a randomized trial, but this effect was not significant calling for further large-scale trials in this vhighly ulnerable patient population.
TRIAL REGISTRATION NUMBER
NCT02517476.
Item Type: |
Journal Article (Original Article) |
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Division/Institute: |
04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Endocrinology, Diabetology and Clinical Nutrition |
UniBE Contributor: |
Stanga, Zeno |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
2044-6055 |
Publisher: |
BMJ Publishing Group |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
19 Aug 2024 08:06 |
Last Modified: |
19 Aug 2024 08:15 |
Publisher DOI: |
10.1136/bmjopen-2024-084754 |
PubMed ID: |
39153787 |
Uncontrolled Keywords: |
DIABETES & ENDOCRINOLOGY NUTRITION & DIETETICS Nutritional support Randomized Controlled Trial |
BORIS DOI: |
10.48350/199819 |
URI: |
https://boris.unibe.ch/id/eprint/199819 |