Li Yu-xiu, Zeng Jing-bo, Yu Kang, Sun Qi, Liu Qiu-ying, Qin Wei, Zhang Qian, Yu Jian-chun, Wang Heng
Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Beijing 100730, China.
Chin Med J (Engl). 2008 Apr 20;121(8):691-5.
This prospective, randomized, controlled study was designed to investigate the effects of a diabetes specific formula (Diason low energy: 313.8 kJ/100 ml), compared with a standard formula, on insulin sensitivity, serum C peptide, serum lipids and free fatty acid (FFA) in type 2 diabetics.
In total of 71 type 2 diabetics completed the study. Enteral formulas were given orally as the sole source of nutrition to the subjects for 6 days. Venous blood samples (0.5, 1, 2, 3 hours) were collected at day-7 after a 75 g oral glucose tolerance test (OGTT), day 1 after a standard test meal (1673.6 kJ) and after 6 days of either the test diabetes specific formula or a standard formula. Plasma glucose, serum insulin, C peptide and lipids were measured.
After the intervention period, the diabetes specific formula resulted in a significantly lower postprandial rise in blood glucose concentrations at 0.5 hour (P < 0.05) and 1 hour (P < 0.01); significantly lower peak height of plasma glucose (P = 0.05); significantly lower plasma insulin concentrations at 0.5 hour (P < 0.01), 1 hour (P < 0.01) and 2 hours (P < 0.01); and a significantly lower plasma insulin peak compared to controls; both OGTT and a standard test meal (P < 0.05). The glucose and insulin area under the curve after the diabetes specific formula compared to the standard formula were significantly lower. The C peptide level was lower after 6 days of both nutrition formulas compare to 75 g OGTT, but not different from the standard mixed meal. Both formulas were well tolerated.
In summary the diabetes specific formula with a relatively high monounsaturated fatty acid and high multi fiber proportion significantly improved glycemic control. On top of this, the insulin sensitivity (HOMA-IS) was significantly improved and may therefore directly improve the impact on long term complications. The disease specific formula should therefore be the preferred option to be used by diabetic and hyperglycemic patients in need of nutritional support.
本前瞻性、随机、对照研究旨在调查一种糖尿病专用配方奶粉（Diason低能量型：313.8千焦/100毫升）与标准配方奶粉相比，对2型糖尿病患者胰岛素敏感性、血清C肽、血脂和游离脂肪酸（FFA）的影响。
共有71名2型糖尿病患者完成了该研究。将肠内配方奶粉作为唯一营养来源口服给予受试者6天。在75克口服葡萄糖耐量试验（OGTT）后第7天、标准试验餐（1673.6千焦）后第1天以及在给予试验性糖尿病专用配方奶粉或标准配方奶粉6天后，采集静脉血样（0.5、1、2、3小时）。检测血浆葡萄糖、血清胰岛素、C肽和血脂。
干预期后，糖尿病专用配方奶粉导致餐后0.5小时（P<0.05）和1小时（P<0.01）血糖浓度的升高显著降低；血浆葡萄糖峰值高度显著降低（P=0.05）；0.5小时（P<0.01）、1小时（P<0.01）和2小时（P<0.01）的血浆胰岛素浓度显著降低；与对照组相比，血浆胰岛素峰值显著降低；无论是OGTT还是标准试验餐（P<0.05）。与标准配方奶粉相比，糖尿病专用配方奶粉后的葡萄糖和胰岛素曲线下面积显著更低。两种营养配方奶粉喂养6天后的C肽水平均低于75克OGTT，但与标准混合餐无差异。两种配方奶粉耐受性均良好。
总之，具有相对较高单不饱和脂肪酸和高膳食纤维比例的糖尿病专用配方奶粉显著改善了血糖控制。除此之外，胰岛素敏感性（HOMA-IS）显著提高，因此可能直接改善对长期并发症的影响。因此，疾病专用配方奶粉应是需要营养支持的糖尿病和高血糖患者的首选。
