Improved macronutrient composition of meals delivered to people with diabetes in hospital: a pre-post, mixed-methods observational study

Background: Providing meals which meet diverse needs of hospital inpatients is complex, contributing to challenges in optimising glycaemia. We developed menus that improved the appropriateness of macronutrient composition of meals for inpatients with diabetes.

Methods: Qualitative feedback from patients and healthcare professionals prompted the implementation of two new menus: 'diabetes lifestyle' and 'diabetes high energy'. Quantitative nutrition analysis of meals provided to inpatients using new menus was compared to the regular menu. Qualitative surveys were repeated after the implementation of the new menus.

Results: Nutrition analysis demonstrated that meals ordered from the diabetes lifestyle menu (mean energy: 7.85 MJ) comprised less total fat (71 vs. 74 vs. 64 g, p < 0.001), saturated fat (34 vs. 36 vs. 31 g, p < 0.001), carbohydrate (246 vs. 249 vs. 217 g, p < 0.001) and sugar (125 vs. 121 vs. 102 g, p < 0.001) compared to the regular (mean energy: 8.46 MJ) and diabetes high energy menus (mean energy: 8.70 MJ). Meals ordered from the diabetes lifestyle menu provided greater protein (91 g) than the regular (85 g) and diabetes high energy (88 g) menus (p < 0.001) and equivalent fibre (33 vs. 31 vs. 33 g, respectively). After implementation of the new menus, more patients reported that meals met their nutritional needs (19 [95%] vs. 14 [70%], p = 0.04), and more healthcare professionals reported menus for inpatients with diabetes were appropriate (16 [100%] vs. 11 [41%], p < 0.001).

Conclusion: Using the diabetes lifestyle menu improved the macronutrient composition of meals for inpatients with diabetes not at risk of malnutrition.