糖尿病患者的营养不良、肌肉减少症和营养治疗——总体框架和医院护理重点。

IF 2.6 Q3 NUTRITION & DIETETICS

Clinical nutrition ESPEN Pub Date : 2025-08-28 DOI:10.1016/j.clnesp.2025.08.027

Jarvis C. Noronha , Jeffrey I. Mechanick , Rocco Barazzoni , Francisco J. Tarazona-Santabalbina , Charilaos Dimosthenopoulos , Anne Raben , Cyril WC. Kendall , Laura Chiavaroli , John L. Sievenpiper

{"title":"糖尿病患者的营养不良、肌肉减少症和营养治疗——总体框架和医院护理重点。","authors":"Jarvis C. Noronha , Jeffrey I. Mechanick , Rocco Barazzoni , Francisco J. Tarazona-Santabalbina , Charilaos Dimosthenopoulos , Anne Raben , Cyril WC. Kendall , Laura Chiavaroli , John L. Sievenpiper","doi":"10.1016/j.clnesp.2025.08.027","DOIUrl":null,"url":null,"abstract":"<div><h3>Background & aims</h3><div>The prevalence of diabetes is increasing globally and is particularly high among hospitalized patients, presenting challenges for inpatient care. While traditional inpatient management emphasizes glycemic control, medication adjustments, and comorbidity management, malnutrition and muscle loss remain underrecognized factors that significantly influence clinical outcomes. This review aims to highlight the role of malnutrition and muscle dysfunction in hospitalized patients with diabetes and to evaluate the potential of medical nutrition therapy (MNT), particularly diabetes-specific nutrition formulas (DSNFs), to improve patient outcomes.</div></div><div><h3>Methods</h3><div>This narrative review is based on the proceedings of a joint session between the Diabetes Nutrition Study Group (DNSG) and the European Society for Clinical Nutrition and Metabolism (ESPEN). Relevant literature was synthesized to explore the prevalence, pathophysiology, and clinical impact of malnutrition and muscle loss in diabetes, as well as the clinical applications of MNT and DSNFs in hospital and intensive care settings.</div></div><div><h3>Results</h3><div>Malnutrition is prevalent among hospitalized patients with diabetes yet frequently goes undiagnosed, contributing to delayed recovery, increased complications, and functional decline. Muscle mass and function are now recognized as key determinants of metabolic regulation and recovery. Recent advances in diagnostic frameworks, including those developed by the Global Leadership Initiative on Malnutrition (GLIM), offer practical tools for the early identification of malnutrition and sarcopenia. Evidence supports the use of MNT, particularly DSNFs, as a strategy to support glycemic control, preserve muscle mass, and reduce complications in both general hospital and ICU settings.</div></div><div><h3>Conclusions</h3><div>Malnutrition and muscle dysfunction are important but often overlooked components of inpatient diabetes care. Early identification using validated screening tools, coupled with timely implementation of MNT, including DSNFs, offers a promising strategy to improve metabolic management and clinical outcomes in hospitalized and critically ill patients with diabetes.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"70 ","pages":"Pages 8-17"},"PeriodicalIF":2.6000,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Malnutrition, sarcopenia and nutrition therapy for patients with diabetes - A general framework and focus on hospital care\",\"authors\":\"Jarvis C. Noronha , Jeffrey I. Mechanick , Rocco Barazzoni , Francisco J. Tarazona-Santabalbina , Charilaos Dimosthenopoulos , Anne Raben , Cyril WC. Kendall , Laura Chiavaroli , John L. Sievenpiper\",\"doi\":\"10.1016/j.clnesp.2025.08.027\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background & aims</h3><div>The prevalence of diabetes is increasing globally and is particularly high among hospitalized patients, presenting challenges for inpatient care. While traditional inpatient management emphasizes glycemic control, medication adjustments, and comorbidity management, malnutrition and muscle loss remain underrecognized factors that significantly influence clinical outcomes. This review aims to highlight the role of malnutrition and muscle dysfunction in hospitalized patients with diabetes and to evaluate the potential of medical nutrition therapy (MNT), particularly diabetes-specific nutrition formulas (DSNFs), to improve patient outcomes.</div></div><div><h3>Methods</h3><div>This narrative review is based on the proceedings of a joint session between the Diabetes Nutrition Study Group (DNSG) and the European Society for Clinical Nutrition and Metabolism (ESPEN). Relevant literature was synthesized to explore the prevalence, pathophysiology, and clinical impact of malnutrition and muscle loss in diabetes, as well as the clinical applications of MNT and DSNFs in hospital and intensive care settings.</div></div><div><h3>Results</h3><div>Malnutrition is prevalent among hospitalized patients with diabetes yet frequently goes undiagnosed, contributing to delayed recovery, increased complications, and functional decline. Muscle mass and function are now recognized as key determinants of metabolic regulation and recovery. Recent advances in diagnostic frameworks, including those developed by the Global Leadership Initiative on Malnutrition (GLIM), offer practical tools for the early identification of malnutrition and sarcopenia. Evidence supports the use of MNT, particularly DSNFs, as a strategy to support glycemic control, preserve muscle mass, and reduce complications in both general hospital and ICU settings.</div></div><div><h3>Conclusions</h3><div>Malnutrition and muscle dysfunction are important but often overlooked components of inpatient diabetes care. Early identification using validated screening tools, coupled with timely implementation of MNT, including DSNFs, offers a promising strategy to improve metabolic management and clinical outcomes in hospitalized and critically ill patients with diabetes.</div></div>\",\"PeriodicalId\":10352,\"journal\":{\"name\":\"Clinical nutrition ESPEN\",\"volume\":\"70 \",\"pages\":\"Pages 8-17\"},\"PeriodicalIF\":2.6000,\"publicationDate\":\"2025-08-28\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical nutrition ESPEN\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2405457725029134\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"NUTRITION & DIETETICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical nutrition ESPEN","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2405457725029134","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"NUTRITION & DIETETICS","Score":null,"Total":0}

引用次数: 0

摘要

背景与目的：糖尿病的患病率在全球范围内呈上升趋势，住院患者的患病率尤其高，这对住院患者的护理提出了挑战。虽然传统的住院管理强调血糖控制、药物调整和合并症管理，但营养不良和肌肉损失仍然是影响临床结果的重要因素。本综述旨在强调营养不良和肌肉功能障碍在住院糖尿病患者中的作用，并评估医学营养治疗（MNT），特别是糖尿病特异性营养配方（DSNFs）改善患者预后的潜力。方法：这篇叙述性综述是基于糖尿病营养研究组（DNSG）和欧洲临床营养与代谢学会（ESPEN）联合会议的记录。综合相关文献，探讨糖尿病患者营养不良和肌肉损失的患病率、病理生理学和临床影响，以及MNT和dsnf在医院和重症监护环境中的临床应用。结果：营养不良在糖尿病住院患者中普遍存在，但经常未得到诊断，导致恢复延迟，并发症增加和功能下降。肌肉质量和功能现在被认为是代谢调节和恢复的关键决定因素。诊断框架的最新进展，包括由营养不良问题全球领导倡议（GLIM）制定的诊断框架，为早期发现营养不良和肌肉减少症提供了实用工具。有证据支持在普通医院和ICU环境中使用MNT，特别是DSNFs作为支持血糖控制、保持肌肉质量和减少并发症的策略。结论：营养不良和肌肉功能障碍是糖尿病住院患者护理的重要组成部分，但往往被忽视。使用经过验证的筛查工具进行早期识别，加上及时实施MNT，包括DSNFs，为改善住院和危重糖尿病患者的代谢管理和临床结果提供了一种有希望的策略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Malnutrition, sarcopenia and nutrition therapy for patients with diabetes - A general framework and focus on hospital care

Background & aims

The prevalence of diabetes is increasing globally and is particularly high among hospitalized patients, presenting challenges for inpatient care. While traditional inpatient management emphasizes glycemic control, medication adjustments, and comorbidity management, malnutrition and muscle loss remain underrecognized factors that significantly influence clinical outcomes. This review aims to highlight the role of malnutrition and muscle dysfunction in hospitalized patients with diabetes and to evaluate the potential of medical nutrition therapy (MNT), particularly diabetes-specific nutrition formulas (DSNFs), to improve patient outcomes.

Methods

This narrative review is based on the proceedings of a joint session between the Diabetes Nutrition Study Group (DNSG) and the European Society for Clinical Nutrition and Metabolism (ESPEN). Relevant literature was synthesized to explore the prevalence, pathophysiology, and clinical impact of malnutrition and muscle loss in diabetes, as well as the clinical applications of MNT and DSNFs in hospital and intensive care settings.

Results

Malnutrition is prevalent among hospitalized patients with diabetes yet frequently goes undiagnosed, contributing to delayed recovery, increased complications, and functional decline. Muscle mass and function are now recognized as key determinants of metabolic regulation and recovery. Recent advances in diagnostic frameworks, including those developed by the Global Leadership Initiative on Malnutrition (GLIM), offer practical tools for the early identification of malnutrition and sarcopenia. Evidence supports the use of MNT, particularly DSNFs, as a strategy to support glycemic control, preserve muscle mass, and reduce complications in both general hospital and ICU settings.

Conclusions

Malnutrition and muscle dysfunction are important but often overlooked components of inpatient diabetes care. Early identification using validated screening tools, coupled with timely implementation of MNT, including DSNFs, offers a promising strategy to improve metabolic management and clinical outcomes in hospitalized and critically ill patients with diabetes.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

Clinical nutrition ESPEN NUTRITION & DIETETICS-

CiteScore

4.90

自引率

3.30%

发文量

512

期刊介绍： Clinical Nutrition ESPEN is an electronic-only journal and is an official publication of the European Society for Clinical Nutrition and Metabolism (ESPEN). Nutrition and nutritional care have gained wide clinical and scientific interest during the past decades. The increasing knowledge of metabolic disturbances and nutritional assessment in chronic and acute diseases has stimulated rapid advances in design, development and clinical application of nutritional support. The aims of ESPEN are to encourage the rapid diffusion of knowledge and its application in the field of clinical nutrition and metabolism. Published bimonthly, Clinical Nutrition ESPEN focuses on publishing articles on the relationship between nutrition and disease in the setting of basic science and clinical practice. Clinical Nutrition ESPEN is available to all members of ESPEN and to all subscribers of Clinical Nutrition.