Effects of nutritional intervention to improve nutritional status and blood lipids for home-Care diabetes patients

Diabetes is the fourth leading cause of death of people in Taiwan. There are about one 1 million diabetic patients in Taiwan, and medical costs account for 1/8 of health insurance funds. Goals for diabetic dietary therapeutics are to control total caloric intake, provide an appropriate ratio of nutrient and fiber intake, and maintain stable blood sugar control; these will help reduce the occurrence of complications. Because home care patients receive no nutritional interventions, and caregivers have low or inadequate nutritional knowledge, the instability of blood sugar control caused by inappropriate nutritional support will affect the utilization of nutrients. In this study, a high-fiber diabetes nutritional formula provided a portion of the source of nutrition for diabetic patients. We assessed the effects of improving the nutritional status of poor-nutrition patients using indicators such as maintaining blood sugar levels and a better nutritional status. Thirty-nine cases were recruited in this study. The enrollment criteria were home care patients either with diabetes (fasting blood sugar of 126~180 mg/dL, having been diagnosed as having diabetes, having 6.5 % < HbA1c < 7.2 % and considered to be underweight (with a body mass index of < 18 kg/m2) , having lower serum albumin than normal (< 3.5 g/dL) , or having been assessed as being malnourished, with a poor dietary intake or dysphagia (including tube feeding) . The dose of the formula was 500 ± 56 kcal/day, and the duration of the intervention was 40 ± 12 days. Results showed that the subjects' triceps skin fold thickness significantly increased from 1.97 ±0.78 to 2.00 ±0.76 cm (p = 0.005) , serum albumin significantly increased from 4.02 ± 0.46 to 4.18 ± 0.49 g/dL (p = 0.001 ) , serum total protein significantly increased from 7.26 ±0.49 to 7.46 ±0.41 g/dL (p = 0.005) , and triglyceride levels significantly dropped from 158.6 ±89.4 to 126.4 ±59.5 mg/dL (p = 0.008) . This study showed that the high-fiber diabetes nutritional formula could improve diabetes patients' anthropometrics, nutritional status, and blood lipids when provided as a part of the source of nutrition for diabetic patients.