Impact of the Use of Resource® Diabet Plus on Metabolic Control in Patients With T2DM Who Are Malnourished or at Risk of Malnutrition

Disease-related malnutrition (DRM) is a nutritional imbalance caused by a nutrient deficiency resulting from one or more underlying pathologies. It is the main cause of malnutrition in developed countries, with a prevalence of around 30 million people in Europe in 2020. In Spain, it is estimated that around 20-50% of hospitalized patients suffer from DRM, both in acute and chronic conditions. One of the chronic diseases where malnutrition is associated with higher mortality and increased hospital admissions is Type 2 Diabetes Mellitus (T2DM), particularly in the elderly. T2DM is currently one of the most prevalent chronic diseases worldwide, affecting about 10% of the adult population in 2021. Approximately 90% of diagnosed cases of diabetes are type 2, which is not autoimmune-mediated, unlike type 1 (T1DM). T2DM typically develops over time due to factors such as obesity, sedentary lifestyle, high-calorie diets, and aging. Additionally, malnutrition risk is increased in patients with T2DM, which leads to a poorer prognosis.

For the treatment of DRM in diabetic patients, as in other chronic conditions, clinical guidelines recommend a personalized nutritional plan tailored to the patient's needs and characteristics, primarily focused on increasing dietary calorie intake. If this is insufficient, oral nutritional supplements may be necessary. From a clinical perspective, oral nutritional supplements address malnutrition while offering clinical and functional benefits. In diabetic and malnourished patients, it is crucial to maintain good metabolic and glycemic control, which requires diabetes-specific formulas (DSFs).

Unlike standard formulas, which are typically high in carbohydrates, low in lipids, and lack dietary fiber, DSFs contain carbohydrates with low glycemic indices and also include fiber. The purpose of these formulas is to improve the nutritional status of patients without negatively affecting their glycemic profile, aiming for adequate glycated hemoglobin (HbA1c) levels - values under 7% are generally recommended for this population.

Prospective observational studies in malnourished T2DM patients have shown that supplementation with a DSF for at least 12 weeks improves patients' functional and nutritional status, enhances biochemical markers, and does not increase postprandial glucose levels. Additionally, the use of these formulas benefits glycemic and metabolic control in the short and medium term, potentially improving diabetes management and its associated comorbidities, while reducing long-term complications and mortality.

A retrospective study conducted in 2015 in the Spanish diabetic population suggested that this type of DSF may reduce HbA1c in the medium term, facilitating glycemic control and reducing the negative effects of glycemic fluctuations. This could result in a reduced need for insulin as an antidiabetic treatment.