A diabetes-specific enteral formula improves glycemic variability in patients with type 2 diabetes - PubMed (original) (raw)

Clinical Trial

A diabetes-specific enteral formula improves glycemic variability in patients with type 2 diabetes

Carolyn J Alish et al. Diabetes Technol Ther. 2010 Jun.

Abstract

Background: Well-controlled studies have demonstrated that inpatient hyperglycemia is an indicator of poor clinical outcomes, but the use of diabetes-specific enteral formulas in hospitalized patients remains a topic of great debate.

Methods: In two different protocols, postprandial glycemia and insulinemia were measured in 22 subjects with diabetes fed a diabetes-specific or standard formula (protocol 1). Continuous glucose monitoring was used to assess glucose levels in 12 enterally fed patients with diabetes receiving the standard formula followed by the diabetes-specific formula continuously for 5 days each (protocol 2). End points included postprandial glycemia and insulinemia, glycemic variability (mean amplitude of glycemic excursions [MAGE]), mean glucose, and insulin use.

Results: In the postprandial response protocol, the diabetes-specific formula resulted in lower positive areas under the postprandial curve (P < 0.001) and peak glucose (P < 0.001) and insulin (P = 0.017) levels. In the protocol using continuous glucose monitoring, glycemic variability (as measured by MAGE) was lower with continuous administration of the diabetes-specific than the standard formula (64.6 +/- 6.8 mg/dL vs. 110.6 +/-15.3 mg/dL, P = 0.003). Also, administration of the diabetes-specific formula resulted in lower mean glucose concentrations during feeding (171.1 +/- 16.1 vs. 202.1 +/- 17.4 mg/dL, P = 0.024) and insulin requirements (7.8 +/- 2.3 vs. 10.9 +/- 3.3 units/day, P = 0.039) than the standard formula.

Conclusions: Relative to the standard formula, the diabetes-specific formula reduced postprandial glycemia, mean glucose, glycemic variability, and short-acting insulin requirements. These results suggest potential clinical usefulness of a diabetes-specific enteral formula for minimizing glycemic excursions in hospitalized patients.

Trial registration: ClinicalTrials.gov NCT00520065 NCT00544206.

PubMed Disclaimer

Cited by

Diabetes-Specific Formulae Versus Standard Formulae as Enteral Nutrition to Treat Hyperglycemia in Critically Ill Patients: Protocol for a Randomized Controlled Feasibility Trial.
Doola R, Todd AS, Forbes JM, Deane AM, Presneill JJ, Sturgess DJ. Doola R, et al. JMIR Res Protoc. 2018 Apr 9;7(4):e90. doi: 10.2196/resprot.9374. JMIR Res Protoc. 2018. PMID: 29631990 Free PMC article.
Health-Care Costs, Glycemic Control and Nutritional Status in Malnourished Older Diabetics Treated with a Hypercaloric Diabetes-Specific Enteral Nutritional Formula.
Sanz-Paris A, Boj-Carceller D, Lardies-Sanchez B, Perez-Fernandez L, Cruz-Jentoft AJ. Sanz-Paris A, et al. Nutrients. 2016 Mar 9;8(3):153. doi: 10.3390/nu8030153. Nutrients. 2016. PMID: 27005661 Free PMC article.
Classifying Enteral Nutrition: Tailored for Clinical Practice.
Limketkai BN, Shah ND, Sheikh GN, Allen K. Limketkai BN, et al. Curr Gastroenterol Rep. 2019 Jul 31;21(9):47. doi: 10.1007/s11894-019-0708-3. Curr Gastroenterol Rep. 2019. PMID: 31368086 Review.
Continuous versus bolus tube feeds: Does the modality affect glycemic variability, tube feeding volume, caloric intake, or insulin utilization?
Evans DC, Forbes R, Jones C, Cotterman R, Njoku C, Thongrong C, Tulman D, Bergese SD, Thomas S, Papadimos TJ, Stawicki SP. Evans DC, et al. Int J Crit Illn Inj Sci. 2016 Jan-Mar;6(1):9-15. doi: 10.4103/2229-5151.177357. Int J Crit Illn Inj Sci. 2016. PMID: 27051616 Free PMC article.
Medical nutrition therapy in hospitalized patients with diabetes.
Gosmanov AR, Umpierrez GE. Gosmanov AR, et al. Curr Diab Rep. 2012 Feb;12(1):93-100. doi: 10.1007/s11892-011-0236-5. Curr Diab Rep. 2012. PMID: 21997598 Free PMC article. Review.

A diabetes-specific enteral formula improves glycemic variability in patients with type 2 diabetes - PubMed (original) (raw)