title: Effects of a novel palatinose based enteral formula (MHN-01) carbohydrate-adjusted fluid diet in improving the metabolism of carbohydrates and lipids in patients with esophageal cancer complicated by diabetes mellitus.
abstract: BACKGROUND
  During perioperative management of patients with gastrointestinal cancer complicated by diabetes mellitus, adequate alimentation is required, but we often face difficulties associated with hyperglycemia and other accompanying complications. Recently, we investigated the effects of a novel palatinose based enteral formula (MHN-01) in suppressing post-prandial hyperglycemia and improving lipid metabolism in experimental animals and perioperative management of patients with esophageal cancer complicated by diabetes mellitus.
  
  
  METHODS
  We gave normal rats and rats with type 2 diabetes mellitus a single oral dose of fluid diet, and analyzed comparatively the time course of blood glucose level in each group until 3 h after the dose. In both the normal rat group and the type 2 diabetes group, peak blood glucose level after the MHN-01 dose was significantly lower than after a dose of ordinary fluid diet and was comparable to the peak level after a dose of a fluid diet rich in MUFA (monounsaturated fatty acid). We allowed normal mice free access to fluid diet for 43 days, and measured their body fat levels. Fat accumulation was significantly lower in mice given MHN-01 than in mice given ordinary fluid diet. We also analyzed the respiratory quotient and resting energy expenditure of normal Sprague-Dawley rats fed by MHN-01 or an ordinary fluid diet. The respiratory quotient of the MHN-01 group was significantly lower than the ordinary fluid group, although the resting energy expenditure of both groups was almost the same level. The effect of MHN-01 was estimated to be based on improvement of lipid metabolism.
  
  
  RESULTS
  Between 2003 and 2005, among 164 patients who underwent radical thoracic esophagectomy and/or reconstruction for esophageal carcinoma at Okayama University Hospital, nine patients (5.5%) were diagnosed with diabetes mellitus in pre-operative screening and were treated with MHN-01. Clinical courses of two cases with severe status of diabetes mellitus were presented as successful case reports of MHN-01.
  
  
  CONCLUSIONS
  MHN-01 was very useful in perioperative management of patients complicated by diabetes mellitus, unable to ingest food p.o. such as esophageal cancer or other diseases.
authors.affiliation: Department of Gastroenterological Surgery, Transplant and Surgical Oncology, Okayama University, Okayama, Japan.
authors.forename: Toshiya
authors.initials: T
authors.lastname: Fujiwara
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Naomoto
authors.forename: Takayuki
authors.initials: T
authors.lastname: Motoki
authors.forename: Kaori
authors.initials: K
authors.lastname: Shigemitsu
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Shirakawa
authors.forename: Tomoki
authors.initials: T
authors.lastname: Yamatsuji
authors.forename: Masafumi
authors.initials: M
authors.lastname: Kataoka
authors.forename: Minoru
authors.initials: M
authors.lastname: Haisa
authors.forename: Toshiyoshi
authors.initials: T
authors.lastname: Fujiwara
authors.forename: Maritoki
authors.initials: M
authors.lastname: Egi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Morimatsu
authors.forename: Motohiko
authors.initials: M
authors.lastname: Hanazaki
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Katayama
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Morita
authors.forename: Kenji
authors.initials: K
authors.lastname: Mizumoto
authors.forename: Takanobu
authors.initials: T
authors.lastname: Asou
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Arima
authors.forename: Hajime
authors.initials: H
authors.lastname: Sasaki
authors.forename: Motoi
authors.initials: M
authors.lastname: Matsuura
authors.forename: Mehmet
authors.initials: M
authors.lastname: Gunduz
authors.forename: Noriaki
authors.initials: N
authors.lastname: Tanaka
mesh_terms: D000368:Aged; D000818:Animals; D001786:Blood Glucose / Q000378:metabolism; D001835:Body Weight; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000178:diet therapy*; D004040:Dietary Carbohydrates / Q000008:administration & dosage* / Q000493:pharmacokinetics; D004041:Dietary Fats / Q000008:administration & dosage* / Q000493:pharmacokinetics; D004734:Energy Metabolism; D004750:Enteral Nutrition / Q000379:methods*; D004938:Esophageal Neoplasms / Q000150:complications / Q000178:diet therapy* / Q000601:surgery; D005229:Fatty Acids, Monounsaturated / Q000493:pharmacokinetics; D006801:Humans; D006943:Hyperglycemia / Q000150:complications / Q000188:drug therapy; D007534:Isomaltose / Q000031:analogs & derivatives* / Q000737:chemistry / Q000627:therapeutic use; D008297:Male; D051379:Mice; D008810:Mice, Inbred C57BL; D008875:Middle Aged; D051381:Rats; D017207:Rats, Sprague-Dawley
chemical_list: D001786:Blood Glucose; D004040:Dietary Carbohydrates; D004041:Dietary Fats; D005229:Fatty Acids, Monounsaturated; D007534:Isomaltose; C008189:isomaltulose