Utilization of Diabetes-Specific Nutrition among Community-Dwelling Malnourished People with Diabetes: Results of a Quality Improvement Program

Diabetes-specific nutrition could play an important role in the overall management of diabetes. Diabetes-specific nutritional formulas (DSNF) could be beneficial for the management of people with diabetes (PWD) who are malnourished or at risk. The role of primary care physicians as drivers of DSNF recommendations was assessed via phone surveys in community-dwelling PWD at malnutrition risk participating in a home-based nutrition focused quality improvement program (QIP). Of patients surveyed, 93.2% were still using DSNF within 30-45 days of enrollment in QIP and 238 of 266 (89%) were “very-” or “somewhat-” likely to continue DSNF if they were recommended by a physician. In PWD receiving home healthcare, patient education, and professional recommendation of DSNF by physicians could reinforce utilization and better adherence. Hospitalization rates were also reduced for patients enrolled in the QIP as compared to at-risk/malnourished pre-QIP historical PWD controls; relative risk reductions were 21.7% at 30 days (12.6% vs. 16.1%, p=0.053), 28.1% at 60 days (17.9% vs. 24.9%, p=0.001), and 28.3% at 90 days (21.8% vs. 30.4%, p<0.001). Nutrition-focused QIPs and physician driven recommendations for DSNF can improve patient engagement in nutrition therapy and decrease hospitalization rates.