title: The effect of a low-carbohydrate/high-monounsaturated fatty acid liquid diet and an isoleucine-containing liquid diet on 24-h glycemic variability in diabetes patients on tube feeding: a comparison by continuous glucose monitoring.
abstract: OBJECTIVE
  This study compare the effect of various liquid diets on 24-h glycemic variability in diabetes patients on tube feeding.
  
  
  METHODS
  The study included type 2 diabetes patients in whom percutaneous endoscopic gastrostomy had been performed for dysphagia as a sequela of cerebrovascular disease and who had been put on tube feeding with a standard high-carbohydrate liquid diet (HCD). Once stable glycemic control was achieved, these patients were continuously monitored for glucose levels for 5 days on continuous glucose monitoring. Of the 14 patients included, seven were given HCD on day 1, a low-carbohydrate/high-monounsaturated fatty acid liquid diet (LCD) on Days 2 and 3, and a isoleucine-containing liquid diet (ICD), which is known to promote glycemic uptake by skeletal muscle, thus suppressing increases in glucose levels, on Days 4 and 5, with the remaining seven given the same diets but ICD given on Days 2 and 3 and LCD given on Days 4 and 5. All comparisons were made under the same caloric conditions (caloric intake, 800-1200 kcal/day).
  
  
  RESULTS
  The 24-h mean glucose level was significantly lower with LCD and ICD than with HCD but was also significantly lower with LCD than with ICD. On the other hand, the SD of 288 glucose levels over a 24-h period, 24-h total area for glycemic fluctuations, and mean amplitude of glycemic excursion were significantly lower with LCD than with HCD or ICD, whereas they did not differ significantly between HCD and ICD.
  
  
  CONCLUSIONS
  LCD and ICD led to significant decreases in mean glucose levels, compared with HCD. However, of the diets compared, LCD had the greatest effect on glycemic variability in these patients on tube feeding.
authors.affiliation: Division of Diabetes and Endocrinology, Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan. morisumikojp@yahoo.co.jp
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Mori
authors.forename: Teruo
authors.initials: T
authors.lastname: Ohta
authors.forename: Masatsugu
authors.initials: M
authors.lastname: Shiozaki
authors.forename: Junichi
authors.initials: J
authors.lastname: Yokoyama
authors.forename: Kazunori
authors.initials: K
authors.lastname: Utsunomiya
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D015190:Blood Glucose Self-Monitoring; D018592:Cross-Over Studies; D003680:Deglutition Disorders / Q000178:diet therapy* / Q000503:physiopathology / Q000601:surgery; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000178:diet therapy* / Q000503:physiopathology; D050528:Diet, Carbohydrate-Restricted; D002149:Energy Intake; D004750:Enteral Nutrition / Q000379:methods; D005229:Fatty Acids, Monounsaturated / Q000008:administration & dosage*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007532:Isoleucine / Q000008:administration & dosage*; D008297:Male; D011446:Prospective Studies
chemical_list: D001786:Blood Glucose; D005229:Fatty Acids, Monounsaturated; D006442:Glycated Hemoglobin; D007532:Isoleucine; C517652:hemoglobin A1c protein, human