The effect of different nutritional feeds on the postprandial glucose response in healthy volunteers and patients with type II diabetes

Hofman, Zandrie; Drunen, J.D.E. Van; Later, C de; Kuipers, H.

doi:10.1038/sj.ejcn.1602007

Cited by 42 publications

(34 citation statements)

References 19 publications

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“…majority of the studies the diabetesspecific formulas showed lower triglyceride concentrations than the standard formulas, the combined data from four RCTs (14,38,44,45) indicated no significant effect (effect size Ϫ0.11 [95%CI Ϫ0.5 to 0.28], r ϭ 0; effect size Ϫ0.13 [Ϫ0.53 to 0.26], r ϭ 0.5) ( Table 1). Furthermore, two other long-term RCTs (49,54) reported no significant effect of diabetes-specific versus standard formulas on triglycerides, whereas the findings of a short-term RCT were unclear (48). None of these studies provided any detailed data.…”

Section: Lipidemia (Total Cholesterol Hdl and Triglycerides)mentioning

confidence: 99%

“…However, the methodology of individual RCTs was often poorly described (with regard to methods of randomization, blinding, and recording number of drop-outs), with only three studies (45,47,48) scoring the top grade of five on the Jadad scale (34). The remaining RCTs scored four (46,49), three (38,54), two (11,14,39 -44,50,52), or one (51,53).…”

Section: Overall Search Findingsmentioning

confidence: 99%

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Enteral Nutritional Support and Use of Diabetes-Specific Formulas for Patients With Diabetes

et al. 2005

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OBJECTIVE -The aim of this systematic review was to determine the benefits of nutritional support in patients with type 1 or type 2 diabetes.RESEARCH DESIGN AND METHODS -Studies utilizing an enteral nutritional support intervention (oral supplements or tube feeding) were identified using electronic databases and bibliography searches. Comparisons of interest were nutritional support versus routine care and standard versus diabetes-specific formulas (containing high proportions of monounsaturated fatty acids, fructose, and fiber). Outcomes of interest were measures of glycemia and lipid status, medication requirements, nutritional status, quality of life, complications, and mortality. Meta-analyses were performed where possible.RESULTS -A total of 23 studies (comprising 784 patients) of oral supplements (16 studies) and tube feeding (7 studies) were included in the review, and the majority compared diabetesspecific with standard formulas. Compared with standard formulas, diabetes-specific formulas significantly reduced postprandial rise in blood glucose (by 1.03 mmol/l [95% CI 0.58 -1.47]; six randomized controlled trials [RCTs]), peak blood glucose concentration (by 1.59 mmol/l [86 -2.32]; two RCTs), and glucose area under curve (by 7.96 mmol ⅐ l Ϫ1 ⅐ min Ϫ1 [2.25-13.66]; four RCTs, i.e., by 35%) with no significant effect on HDL, total cholesterol, or triglyceride concentrations. In addition, individual studies reported a reduced requirement for insulin (26 -71% lower) and fewer complications with diabetes-specific compared with standard nutritional formulas.CONCLUSIONS -This systematic review shows that short-and long-term use of diabetesspecific formulas as oral supplements and tube feeds are associated with improved glycemic control compared with standard formulas. If such nutritional support is given long term, this may have implications for reducing chronic complications of diabetes, such as cardiovascular events. Diabetes Care 28:2267-2279, 2005T he impact of better glycemic control on long-term clinical outcome is well recognized in both type 1 (1) and type 2 (2) diabetes, where hyperglycemia may result in life-threatening complications and numerous comorbidities. In addition, many conditions, including accidental injury, stroke, and critical illness, show a worse outcome in the presence of hyperglycemia (3).In the U.K., the costs associated with major hyperglycemic complications range from £872 (€1,256 or $1,607 for blindness in one eye) to £8,459 (€12,178 or $15,591 for amputation) per patient (4), and the U.S. has reported annual diabetes health care costs of $11,157 (€8,710) per patient (5). This large economic burden is unsurprising given that patients with diabetes are known to be admitted to the hospital more often than other patient groups, accounting for up to 25% of intensive care admissions (3,6). Many of these hospitalized patients will require nutritional support. In addition, an increasing number of patients receive long-term home enteral tube feeding (ETF), including those with diabetes (7...

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Section: Lipidemia (Total Cholesterol Hdl and Triglycerides)mentioning

confidence: 99%

Section: Overall Search Findingsmentioning

confidence: 99%

Enteral Nutritional Support and Use of Diabetes-Specific Formulas for Patients With Diabetes

et al. 2005

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“…Comme attendu, avec ces modifications, on observe une diminution de la réponse glycémique chez le sujet diabétique comme chez le sujet sain [18]. Pour une même quantité de glucides, les produits pour diabétiques ont un IG significativement plus faible (IG = 19,4 ± 1,8 vs 42,1 ± 5,9).…”

Section: Charge Glycémique Des Mélanges Pour Neunclassified

“…Pour une même quantité de glucides, les produits pour diabétiques ont un IG significativement plus faible (IG = 19,4 ± 1,8 vs 42,1 ± 5,9). Les produits nutritifs standards ont des IG considérés comme faibles (< 55) ou modérés (55 à 70) [18].…”

Section: Charge Glycémique Des Mélanges Pour Neunclassified

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Diabète et nutrition artificielle : principes de prise en charge

Quilliot¹,

Malgras²,

Paquot³

et al. 2013

Nutrition Clinique et Métabolisme

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At home as in the hospital, the diabetic patients are at high risk of malnutrition. In patients with hyperglycemia in artificial nutrition, the primary objective is to to cover their protein needs and their caloric needs and to optimize accordingly the antidiabetic treatment. Insulin therapy is the treatment of choice. The use of low glycaemic index is probably better, especially for oral supplementation. An equivalent parenteral carbohydrate intake has a hyperglycaemic effect more important than with the oral or enteral way. The management of hyperglycemia in artificial nutrition requires defining glycemic goals, tailored to the patient, to the type and the sequences of artificial nutrition, establishing patterns of insulin therapy and providing accurate adaptation rules. Above the basal requirement, insulin therapy sufficient to meet caloric exposure must be prescribed appropriate in timing with the artificial nutrition. The use of sliding scale as monotherapy is ineffective. This management requires forming the nurse team. The acute phase has passed, the disease stabilized, it is sometimes possible to introduce oral antidiabetic drugs and stop insulin. In this case, we apply the same prescription rules to these drugs as for the patient fed orally.

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Glycemic Response to a Renal‐Specific Oral Nutritional Supplement in Patients With Diabetes Undergoing Hemodialysis: A Randomized Crossover Trial

Patel

Dijk

Malarkey

et al. 2020

J Parenter Enteral Nutr

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Background Diabetes and malnutrition are common in patients with kidney failure. We aimed to evaluate the postprandial glucose response to oral nutritional supplement drinks (ONSs) in patients with diabetes undergoing hemodialysis treatment. Methods A randomized, single‐blind crossover study was conducted in patients with diabetes, and requiring chronic hemodialysis. Patients consumed either a renal‐specific ONS, macronutrient‐matched ONS, or standard ONS on 3 separate study days, during dialysis, following an overnight fast. Blood was collected before and 15, 30, 45, 60, 90, 120, and 180 minutes post ingestion. Mean net incremental area under the curve (iAUC) and peak incremental blood glucose concentration were compared across conditions, using analyses of variance. Results Consumption of the renal‐specific ONS resulted in the lowest mean net iAUC (87.9 ± 169.0 mmol/L per 3 hours) compared with macronutrient‐matched (188.0 ± 127.5 mmol/L per 3 hours) and standard ONS (199.5 ± 169.2 mmol/L per 3 hours) (F2,30 = 5.115, P = 0.012, partial n2 = 0.254). Pairwise comparisons demonstrated a mean difference of 100.1 mmol/L per 3 hours (95% CI, −2.8 to 202.9) in mean iAUC between the renal‐specific ONS and macronutrient‐matched ONS (P = 0.058). Peak blood glucose concentration, corrected for baseline, was significantly lower after the renal‐specific ONS (1.40 ± 1.0 mmol/L) compared with both macronutrient‐matched (2.02 ± 0.71 mmol/L, P = 0.036) and standard ONS (2.3 ± 1.06 mmol/L, P = 0.017). Conclusion A renal‐specific ONS elicits a lower postprandial glucose response than either macronutrient‐matched ONS or standard ONS in patients with diabetes during hemodialysis.

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The effect of different nutritional feeds on the postprandial glucose response in healthy volunteers and patients with type II diabetes

Cited by 42 publications

References 19 publications

Enteral Nutritional Support and Use of Diabetes-Specific Formulas for Patients With Diabetes

Enteral Nutritional Support and Use of Diabetes-Specific Formulas for Patients With Diabetes

Diabète et nutrition artificielle : principes de prise en charge

Glycemic Response to a Renal‐Specific Oral Nutritional Supplement in Patients With Diabetes Undergoing Hemodialysis: A Randomized Crossover Trial

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