Glycemic and lipid control in hospitalized type 2 diabetic patients: evaluation of 2 enteral nutrition formulas (low carbohydrate-high monounsaturated fat vs high carbohydrate).
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).
León-Sanz
Miguel
M
Hospital 12 de Octubre, Madrid, Spain. mleon@h12o.es
García-Luna
Pedro P
PP
Sanz-París
Alejandro
A
Gómez-Candela
Carmen
C
Casimiro
César
C
Chamorro
José
J
Pereira-Cunill
José L
JL
Martin-Palmero
Angeles
A
Trallero
Roser
R
Martínez
José
J
Ordóñez
Francisco Javier
FJ
García-Peris
Pilar
P
Camarero
Emma
E
Gómez-Enterría
Pilar
P
Cabrerizo
Lucio
L
Perez-de-la-Cruz
Antonio
A
Sánchez
Carmen
C
García-de-Lorenzo
Abelardo
A
Rodríguez
Nelly
N
Usán
Luis
L
D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D003924:Diabetes Mellitus, Type 2 / Q000378:metabolism / Q000628:therapy*; D003967:Diarrhea / Q000209:etiology / Q000378:metabolism; D004040:Dietary Carbohydrates / Q000378:metabolism*; D004042:Dietary Fats, Unsaturated / Q000378:metabolism*; D004750:Enteral Nutrition / Q000379:methods*; D005260:Female; D006760:Hospitalization; D006801:Humans; D050356:Lipid Metabolism; D008297:Male; D009325:Nausea / Q000209:etiology / Q000378:metabolism
D001786:Blood Glucose; D004040:Dietary Carbohydrates; D004042:Dietary Fats, Unsaturated