Comparison of Metabolic Clearance Rates of MCT/LCT and LCT Emulsions in Diabetics

Abstract

In seven moderately overweight noninsulin-dependent diabetics with slightly elevated triglyceride levels, disappearance rates of infused medium chain triglyceride/long chain triglyceride (MCT/LCT) and long chain triglyceride (LCT) emulsions were compared. Five metabolically healthy volunteers served as controls. During a 3-hr lipid infusion, serum triglycerides reached a steady state with both emulsions in the healthy controls, whereas, in diabetic patients, steady state triglyceride levels were seen only with MCT/LCT. After the end of the lipid infusion, the longest half-life value in the decline of triglyceride levels was found with LCT in diabetics, whereas significantly shorter and quite similar half-life values were found with LCT in healthy controls and with MCT/LCT in diabetics. As expected, the shortest half-life for serum triglycerides was found in healthy controls after MCT/LCT-infusion. Virtually the same differences in serum concentrations and in half-life times were seen with free fatty acids. According to these data, if needed, parenteral nutrition with lipids in states of disturbed glucose and lipid metabolism may preferentially be done with MCT/LCT emulsions.

Immunomodulation by fish-oil containing lipid emulsions in murine acute respiratory distress syndrome

“…Rapid and extended infusion of such lipid emulsions may thus increase the plasma concentration of free arachidonic acid by one order of magnitude, leading to a modulation of the eicosanoid profile, deterioration of the oxygenation index and alteration of the ventilation-perfusion matching of the lung. The combination of LCT with medium-chain triglycerides (MCT) in a 1:1 ratio was introduced into nutrition regimes as MCT were cleared rapidly from the serum, and displayed less adverse liver outcomes and reduced the provision of n-6 PUFA by 50% [8-10]. The administration of n-3 PUFA, as fish oil (FO), offers a novel promising strategy to enrich nutrition regimes as it has been shown to modulate excessive inflammatory reactions in animals, healthy volunteers and subjects in clinical trials [11].…”

National Consensus on the Use of Sedation Drugs in the Gastrointestinal Endoscopic Procedures

“…16,19,20,21 Pethidine Pharmacokinetics Absorption: absorption occurs rapidly with peak plasma levels reached in about 20-60 minutes.…”

Anesthetic considerations in diabetic patients. Part I: preoperative considerations of patients with diabetes mellitus

“…It is well known that diabetic patients have a reduced ability to clear lipids from the circulation [66]. However, propofol used only as an induction agent is thought to have no adverse effect in diabetic patients.…”