Glycemic and lipid control in hospitalized type 2 diabetic patients: evaluation of 2 enteral nutrition formulas (low carbohydrate-high monounsaturated fat vs high carbohydrate).
Study Goal
The researchers aimed to compare the effects of a high-monounsaturated-fat enteral formula versus a high-carbohydrate formula on glycemic and lipid control in hospitalized type 2 diabetic patients.
Results Summary
The high-monounsaturated-fat formula (Glucerna) showed neutral effects on glycemic control and lipid metabolism compared to the high-carbohydrate formula (Precitene Diabet), which increased mean glucose levels. Glucerna also had better gastrointestinal tolerance, with fewer instances of diarrhea but more nausea than Precitene.
Population
Hospitalized type 2 diabetic patients with neurologic disorders or head and neck cancer surgery.
Effective Dosage
Not specified
Duration
Median 13 days
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
low-carbohydrate-high-mono-unsaturated-fat (Glucerna) diet | no change | mean glucose | type 2 diabetes patients admitted to the hospital for neurologic disorders or head and neck cancer surgery | no significant variations | no significant variations | #1 |
high-carbohydrate diet (Precitene Diabet) | increase | mean glucose | type 2 diabetes patients admitted to the hospital for neurologic disorders or head and neck cancer surgery | - | significantly increased | #2 |
high-carbohydrate diet (Precitene Diabet) | increase | mean weekly blood triglycerides levels | type 2 diabetes patients admitted to the hospital for neurologic disorders or head and neck cancer surgery | without reaching statistical significance | increased | #3 |
low-carbohydrate-high-mono-unsaturated-fat (Glucerna) diet | no change | mean weekly blood triglycerides levels | type 2 diabetes patients admitted to the hospital for neurologic disorders or head and neck cancer surgery | - | showed a stable trend | #4 |
high-carbohydrate diet (Precitene Diabet) | increase | diarrhea | type 2 diabetes patients admitted to the hospital for neurologic disorders or head and neck cancer surgery | - | showed a significantly higher incidence | #5 |
high-carbohydrate diet (Precitene Diabet) | decrease | nausea | type 2 diabetes patients admitted to the hospital for neurologic disorders or head and neck cancer surgery | - | incidence was smaller | #6 |
enteral formula with lower carbohydrate and higher monounsaturated fat (Glucerna) | no change | glycemic control and lipid metabolism | type 2 diabetic patients | - | has a neutral effect | #7 |
BACKGROUND: Type 2 diabetic patients may need enteral nutrition support as part of their treatment. The objective was to compare glycemic and lipid control in hospitalized patients with type 2 diabetes requiring feeding via nasogastric tube using enteral feedings with either a highcarbohydrate or a high-monounsaturated-fat content. METHODS: This trial included type 2 diabetes patients admitted to the hospital for neurologic disorders or head and neck cancer surgery who received either a low-carbohydrate-high-mono-unsaturated-fat (Glucerna) or a high-carbohydrate diet (Precitene Diabet). Glycemic and lipid control was determined weekly. Safety and gastrointestinal tolerance were also assessed. RESULTS: A total of 104 patients were randomized and 63 were evaluable according to preestablished protocol criteria. Median duration of therapy was 13 days in both groups. Mean glucose was significantly increased at 7 days of treatment (p = .006) in the Precitene arm, with no significant variations in the Glucerna arm. Mean weekly blood triglycerides levels in the Precitene arm were increased without reaching statistical significance, whereas patients in the Glucerna arm showed a stable trend. Patients in the Precitene arm showed a significantly higher incidence of diarrhea than patients in Glucerna arm (p = .008), whereas the incidence of nausea was smaller in the Precitene arm than in the Glucerna arm (p = .03). CONCLUSIONS: An enteral formula with lower carbohydrate and higher monounsaturated fat (Glucerna) has a neutral effect on glycemic control and lipid metabolism in type 2 diabetic patients compared with a high-carbohydrate and a lower-fat formula (Precitene Diabet).