Diabetes-specific formulas are an effective alternative for providing nutrients and maintaining glycemic control. This study assesses the effect of treatment with an oral enteral nutrition with a hypercaloric diabetes-specific formula (HDSF) for one year, on health-care resources use, health-care costs, glucose control and nutritional status, in 93 type-2 diabetes mellitus (T2DM) malnourished patients. Changes in health-care resources use and health-care costs were collected the year before and during the year of intervention. Glucose status and nutritional laboratory parameters were analyzed at baseline and one-year after the administration of HDSF. The administration of HDSF was significantly associated with a reduced use of health-care resources, fewer hospital admissions (54.7%; p < 0.001), days spent at hospital (64.1%; p < 0.001) and emergency visits (57.7%; p < 0.001). Health-care costs were reduced by 65.6% (p < 0.001) during the intervention. Glycemic control (short- and long-term) and the need of pharmacological treatment did not change, while some nutritional parameters were improved at one year (albumin: +10.6%, p < 0.001; hemoglobin: +6.4%, p = 0.026). In conclusion, using HDSF in malnourished older type-2 diabetic patients may allow increasing energy intake while maintaining glucose control and improving nutritional parameters. The use of health-care resources and costs were significantly reduced during the nutritional intervention.

Background: Malnourishment is a common complication in patients with Crohn’s disease. Methods: An observational, prospective study was conducted to assess the nutritional status, disease activity, and stool frequency at baseline and after 12 weeks of treatment with a semi-elemental diet in patients with active Crohn’s disease. Results: A total of 144 patients with Crohn’s disease were included. The nutritional status improved after treatment, resulting in 76.1% of patients at low risk of malnourishment, 20.4% moderately malnourished, and 8.5% severely malnourished after 12 weeks of treatment. Nutritional status improvement was associated with the number of nutritional supplements. Mean albumin levels and body mass index (BMI) improved after 12 weeks of nutritional treatment (from 3.0 g/dL to 3.7 g/dL and from 20.2 kg/m² to 21.1 kg/m², respectively). A significant decrease in HBI was found after 12 weeks of nutritional treatment (from 10.2 to 3.7). The mean number of stools per day decreased with the 12 week semi-elemental diet (from 4.6 stools/day to 1.7 stools/day). Conclusion: In this observational study, the semi-elemental diet seemed effective in improving the nutritional status, disease activity, and stool frequency in patients with active Crohn’s disease.

Sarcopenia and malnutrition are both commonly occurring conditions in elderly population. As understood today, sarcopenia is a syndrome characterised by progressive and generalised loss of skeletal muscle mass, physical performance and/or strength, whereas malnutrition has been defined as a condition of an imbalance of energy, protein and other nutrients that can cause measurable negative effects. In many populations, malnutrition and sarcopenia are present simultaneously, and they appear clinically through a combination of decreased body weight and nutrient intake, along with a decrease in muscle mass and function. Moreover, malnutrition is one of the key pathophysiological causes of sarcopenia. Both entities result in numerous and substantial negative outcomes to the patients and the healthcare system, including decreased quality of life and functionality and increased healthcare costs, hospitalisation rates, morbidity and mortality. Early identification of sarcopenia would be of great clinical relevance because the loss of muscle mass and strength with ageing can be largely reversed by proper exercise and nutritional intervention. Clinicians should integrate nutritional assessment with sarcopenia screening for optimal evaluation of these two interrelated issues to help improve clinical outcomes.

Anthropometry is an easy and noninvasive method to evaluate nutritional status in institutionalized elderly people who are often bedridden. The aim of this study was to investigate the relationship between the neck circumference (NC) and nutritional status of elderly nursing home residents and to find cutoff points for NC size to identify individuals at risk of malnutrition. A cross-sectional study was developed with data collected from 352 elderly people living in five public nursing homes. Different anthropometric measures and the Mini Nutritional Assessment (MNA) were used to determine nutritional status. Receiver operating characteristic (ROC) curves were built for each anthropometric variable to determine their sensitivity and specificity for predicting the risk of malnutrition according to the MNA. The mean age of the participants (59% females) was 83 years old. In total, 48.3% of women and 45.5% of men were at risk of malnutrition according to their MNA scores. All anthropometric measurements were highly intercorrelated in both men and women, indicating a high degree of collinearity. Bootstrapped linear regression was used to assess the strength of the association between an individuals' nutritional status and their anthropometric parameters. Calf circumference and NC presented the best predictive value with the highest sensitivity for diagnosing the risk of malnutrition in both institutionalized elderly men and women. The best cutoff points of NC to identify elderly nursing home residents at risk of malnutrition were 35.2 cm for females and 37.8 cm for males. NC is associated with other classical anthropometric parameters and malnutrition status in elderly people living in nursing homes.

Background: Sex differences in type 2 diabetes (T2D) are a growing area of diabetes research. No data have been reported on sex differences with oral semaglutide (oSEMA) in a real-world setting. Methods: We included people with T2D who started treatment with oSEMA in routine clinical practice between November 2021 and November 2022, with at least one report of clinical follow-up (FU) data at 3 months. We evaluated in women with T2D (WWT2D) the clinical effectiveness of oSEMA and factors associated with clinical response and persistence. We also analyzed differences in baseline characteristics, clinical effectiveness, persistence rates and safety according to biological sex. Results: Of the 1018 subjects [median age: 63 years, body mass index (BMI): 33.8 kg/m², HbA1c: 7.8%], 469 were WWT2D. In WWT2D, oSEMA reduced HbA1c by 0.7% [−0.1 to −1.3] and 0.9% [−0.2 to −1.5] at the 6- and 12-month FU visits, while weight decreased by 4.6% [2.0 to 7.9] and 7.2% [2.5 to 10.9], respectively. Weight loss was >10% in 29.8% of WWT2D (95% CI 25.8 to 34.1); meanwhile, the combined endpoint (HbA1c decrease ≥ 1% + weight reduction ≥ 5%) was achieved in 23.5% (95% CI 19.8 to 27.5%) of WWT2D at the 12-month FU visit. Achievement of glycaemic targets was similar in women and men (59.3% vs. 61.1%). We found no sex differences in weight loss (6.9% vs. 6.8%), oSEMA maintenance dose, persistence rate (76.3% vs. 77.3%), or adverse events. Conclusions: oSEMA was effective and safe in WWT2D in a real-world setting, with nearly one-third of patients reporting weight loss >10% and more than two-thirds achieving HbA1c < 7%. oSEMA showed no sex bias in terms of effectiveness and safety.