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Nutrients. 2019 Aug 8;11(8). pii: E1832. doi: 10.3390/nu11081832.

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.
Departments of Internal Medicine "E", Wolfson Medical Center, Holon 58100, Israel.
Departments of Internal Medicine "F", Wolfson Medical Center, Holon 58100, Israel.
Department of Nutrition, Wolfson Medical Center, Holon 58100, Israel.
Department of Nutrition Sciences, Ariel University, Ariel 40700, Israel.



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.


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.


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.


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.


albumin; diabetes mellitus; hypoglycemia; oral nutrition supplement

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