The impact of slow release starch containing enteral nutrition on blood glucose/insulin responses in type 2 diabetic patients — randomized, controlled, multi-center clinical study

Wang, H.; Jiang, Zhikui

doi:10.1016/s0261-5614(03)80056-0

Cited by 1 publication

(3 citation statements)

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“…The results of two other RCTs (40,50) were less conclusive. The data were not sufficiently comparable to permit metaanalysis of this outcome measure.…”

Section: Other Outcomesmentioning

confidence: 73%

“…This study was not meta-analyzable because it provided no measure of variability. In contrast, in a further RCT, where an ONS was given as the sole source of nutrition for 6 days, no differences were found between standard and diabetes-specific formulas, although no numerical data were reported (50).…”

Section: Other Outcomesmentioning

confidence: 73%

“…(61,73,74), the difference was reported to be statistically significant, while the remaining three studies (14,56,59) did not report any statistical analysis. However, these were not meta-analyzable due to incomplete data being reported (41,52,53) or incompatible data presentation (14,50) or study design (42).…”

Section: Other Outcomesmentioning

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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“…The results of two other RCTs (40,50) were less conclusive. The data were not sufficiently comparable to permit metaanalysis of this outcome measure.…”

Section: Other Outcomesmentioning

confidence: 73%

Section: Other Outcomesmentioning

confidence: 73%