The Use of a Specialized Nutritional Supplement for Diabetic Foot Ulcers Reduces the Use of Antibiotics
The Use of a Specialized Nutritional Supplement for Diabetic Foot Ulcers Reduces the Use of Antibiotics
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DOI：
10.4021/jem64w
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发表时间：
2012-02-01
影响因子：
0.4
通讯作者：
Barber, Annabel Elisabeth
中科院分区：
文献类型：
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作者：
Tatti, Patrizio;Barber, Annabel Elisabeth
背景：糖尿病足溃疡(DFU)是糖尿病最致命和最昂贵的并发症之一。我们评估了精氨酸、谷氨酰胺和β-羟基-β-甲基丁酸酯的混合物对22名糖尿病患者作为自身对照的这些病变愈合的影响。在两项研究中，一种含有精氨酸、谷氨酰胺和β-羟基-β-甲基丁酸酯(Ar-Gl-HMB)的营养补充剂显著改善了糖尿病足部溃疡的愈合。谷氨酰胺和精氨酸具有抗菌和增强免疫的作用，应减少抗生素的使用。我们使用两项病例对照研究的数据来评估抗生素的使用和费用。方法：我们确定了22名2型糖尿病患者，他们过去曾因足部神经性溃疡而接受治疗(事件1，E1)，随后又经历了类似特征的复发性溃疡(E2)。在E2中，治疗相同，但受试者接受了Ar-Gl-HMB的补充，并经历了50%的愈合时间。结果：在E1期间，我们使用了83个疗程的抗生素，而在E2期间使用了36个疗程(Wilcoxon SR检验=0.002)。治疗E1的成本为17123.77(SIC)，而E2的成本为8537.8(SIC)。增加2586(SIC)的补充费(8537.8+171223.77=1123.8(SIC))，差异仍然存在。结论：使用该配方可使抗生素治疗费用降低50%。由于愈合时间缩短，直接成本(药物、手术、护理时间等)和间接成本(住院、工作损失天数)都减少了。使用高度专业化的营养可以将抗生素治疗的成本降低约50%，并减少疾病的辅助经济和社会负担。
Background: Diabetic foot ulcers (DFU) are among the most invalidating and costly complications of diabetes. We evaluated the effect of a blend of arginine, glutamine and beta-hydroxy-beta methyl-butyrate on the healing of these lesions in a group of 22 diabetic subjects who served as their own control. A nutritional supplement containing arginine, glutamine and beta-hydroxy-beta-methylbutyrate (Ar-Gl-HMB) dramatically improved the healing of diabetic foot ulcers in two studies. Glutamine and Arginine have an antibacterial and immunopotentiating action and should reduce the use of antibiotics. We evaluated the use and the cost of antibiotics using the data from two case controlled studies of diabetic subjects with recurrent neuropathic diabetic foot ulcers.Methods: We identified 22 subjects with type-2 diabetes who had been treated in the past for neuropathic ulcers of the foot (Event 1, E1), and who subsequently suffered recurrent ulcers with similar characteristics (E2). In E2 the treatment was the same but the subjects received a supplementation of Ar-Gl-HMB, and experienced 50% reduction of time to healing.Results: During E1 we used 83 courses of antibiotics, versus 36 during E2 (Wilcoxon SR test = 0.002). The cost for treatment E1 was 17123.77 (sic), versus 8537.8 (sic) in E2. The difference persists also adding the cost of the supplement of 2586 (sic) (8537.8 + 171223.77 = 1123.8 (sic)).Conclusions: The cost of the antibiotic treatment was reduced by 50% with the use of the formula. Because the time to healing was shortened, both the direct costs (medication, surgery, nursing time, etc) and the indirect costs (hospitalization, days of work lost) were decreased. The use of a highly specialized nutrition reduces the cost of the antibiotic treatment by about 50% and the auxiliary economic and social burden of disease.