DGEM-Leitlinie Enterale Ernährung:Diabetologie

Glycaemic control in type II diabetic tube-fed patients with a new enteral formula low in carbohydrates and high in monounsaturated fatty acids: a randomised controlled trial

“…Guidelines for the nutritional management of diabetes have changed considerably, emphasising in the last years avoidance of foods that cause an exaggerated glycaemic response (ie foods with a high glycaemic index) (American Diabetes Association (ADA), 2000; Coulston, 2000; European Association for the Study of Diabetes (EASD), 2000; Connor et al, 2003;del Carmen Crespillo et al, 2003;Parhofer et al, 2003;Franz et al, 2004;Schafer et al, 2004). In light of this, carbohydrate-modified enteral diets with reduced glycaemic indices have been developed (Haslbeck et al, 1995;Ha & Lean, 1998;American Diabetes Association (ADA), 2002;van Drunen et al, 2003;Franz et al, 2004;Hofman et al, 2004).…”

“…In light of this, carbohydrate-modified enteral diets with reduced glycaemic indices have been developed (Haslbeck et al, 1995;Ha & Lean, 1998;American Diabetes Association (ADA), 2002;van Drunen et al, 2003;Franz et al, 2004;Hofman et al, 2004). Although these diets may reduce nonfasting hyperglycaemia, the ability of type II diabetes mellitus (DM) patients to achieve long-term glycaemic benefit has been questioned (Ha & Lean, 1998; European Association for the Study of Diabetes (EASD), 2000; American Diabetes Association (ADA), 2002; Connor et al, 2003;Parhofer et al, 2003;Franz et al, 2004). As type II DM is also a disorder of lipid metabolism (Wright, 2000), formulas enriched with monounsaturated fatty acids (MUFAs) have been recommended as a strategy to limit intake of polyunsaturated fatty acids (PUFAs) and saturated fatty acids (SFAs) (Fürst, 1998;American Diabetes Association (ADA), 2002;Parhofer et al, 2003;Hofman et al, 2004).…”

“…Although these diets may reduce nonfasting hyperglycaemia, the ability of type II diabetes mellitus (DM) patients to achieve long-term glycaemic benefit has been questioned (Ha & Lean, 1998; European Association for the Study of Diabetes (EASD), 2000; American Diabetes Association (ADA), 2002; Connor et al, 2003;Parhofer et al, 2003;Franz et al, 2004). As type II DM is also a disorder of lipid metabolism (Wright, 2000), formulas enriched with monounsaturated fatty acids (MUFAs) have been recommended as a strategy to limit intake of polyunsaturated fatty acids (PUFAs) and saturated fatty acids (SFAs) (Fürst, 1998;American Diabetes Association (ADA), 2002;Parhofer et al, 2003;Hofman et al, 2004). High MUFA content may increase HDL-and decrease LDL-cholesterol, triacylglycerols, and total cholesterol concentrations, and may improve lipid and glycaemic control (American Diabetes Association (ADA), 2002; Parhofer et al, 2003).…”

“…As type II DM is also a disorder of lipid metabolism (Wright, 2000), formulas enriched with monounsaturated fatty acids (MUFAs) have been recommended as a strategy to limit intake of polyunsaturated fatty acids (PUFAs) and saturated fatty acids (SFAs) (Fürst, 1998;American Diabetes Association (ADA), 2002;Parhofer et al, 2003;Hofman et al, 2004). High MUFA content may increase HDL-and decrease LDL-cholesterol, triacylglycerols, and total cholesterol concentrations, and may improve lipid and glycaemic control (American Diabetes Association (ADA), 2002; Parhofer et al, 2003).…”

“…The optimal diet for persons with diabetes, regardless of whether or not it is administered through tube feeding, has long been a subject of controversy (Eckel, 2004;Gerhard et al, 2004). The evidence for beneficial effects from special enteral formulas in tube-fed insulin-treated patients with type II DM is mainly based on short-term studies (American Diabetes Association (ADA), 2002; Parhofer et al, 2003;Hofman et al, 2004). It still has to be established whether or not long-term use (1-3 months) of special diabetic enteral formulas can result in improved glycaemic control.…”