Vanschoonbeek K, Lansink M, van Laere K M J, Senden J M G, Verdijk L B, van Loon L J C
The Departments of Human Biology, Nutrition and Toxicology Research Institute Maastricht (NUTRIM), Maastricht University, Maastricht, the Netherlands (Dr Vanschoonbeek, Dr van Loon)
Danone Research, Centre for Specialised Nutrition, Wageningen, the Netherlands (Dr Lansink, Dr van Laere)
Diabetes Educ. 2009 Jul-Aug;35(4):631-40. doi: 10.1177/0145721709335466. Epub 2009 May 15.
The purpose of this study is to compare the glycemic and insulinemic responses following the ingestion of recently developed diabetes-specific enteral formulas versus a standard and a high-fat formula.
Fifteen type 2 diabetes patients were selected to participate in a randomized, double-blind, crossover study. Two enteral formulas (47 energy percent [En%] carbohydrate, 34En% fat, and 4 g fiber/200 mL) were defined with either isomaltulose (formula 1) or sucromalt (formula 2) as the main carbohydrate source. For comparison, an isoenergetic diabetes-specific, high-fat (33En% carbohydrate, 50En% fat, 2.9 g fiber/200 mL) and a standard formula (55En% carbohydrate, 30En% fat, 2.8 g fiber/200 mL) were tested.
Ingestion of formulas 1 and 2 and the high-fat formula resulted in an attenuated blood glucose response when compared with the standard formula (P < .05). In accordance, peak plasma glucose concentrations were significantly lower when compared with the standard formula (189 +/- 3.6 mg/dL [10.5 +/- 0.2 mmol/L], 196.2 +/- 3.6 mg/dL [10.9 +/- 0.2 mmol/L], 187.2 +/- 3.6 mg/dL [10.4 +/- 0.2 mmol/L], and 237.6 +/- 3.6 mg/dL [13.2 +/- 0.2 mmol/L], respectively). Plasma insulin responses were lower after consumption of the newly developed and high-fat formulas. Ingestion of the high-fat formula resulted in a greater postprandial triglyceride response (P < .05).
Diabetes-specific enteral formulas rich in slowly digestible carbohydrate sources can be equally effective in attenuating the postprandial blood glucose response as low-carbohydrate, high-fat enteral formulas without elevating the plasma triglyceride response.
本研究旨在比较摄入最近开发的糖尿病专用肠内营养配方与标准配方和高脂配方后的血糖和胰岛素反应。
选择15名2型糖尿病患者参与一项随机、双盲、交叉研究。定义了两种肠内营养配方（碳水化合物供能47%[En%]、脂肪供能34%En%，每200 mL含4 g纤维），分别以异麦芽酮糖醇（配方1）或蔗糖麦芽糖（配方2）作为主要碳水化合物来源。为作比较，测试了等能量的糖尿病专用高脂配方（碳水化合物供能33%En%、脂肪供能50%En%，每200 mL含2.9 g纤维）和标准配方（碳水化合物供能55%En%、脂肪供能30%En%，每200 mL含2.8 g纤维）。
与标准配方相比，摄入配方1、配方2和高脂配方后血糖反应减弱（P<0.05）。相应地，与标准配方相比，血浆葡萄糖峰值浓度显著降低（分别为189±3.6 mg/dL[10.5±0.2 mmol/L]、196.2±3.6 mg/dL[10.9±0.2 mmol/L]、187.2±3.6 mg/dL[（10.4±0.2 mmol/L]和237.6±3.6 mg/dL[13.2±0.2 mmol/L]）。摄入新开发的配方和高脂配方后血浆胰岛素反应较低。摄入高脂配方导致餐后甘油三酯反应更大（P<0.05）。
富含缓慢消化碳水化合物来源的糖尿病专用肠内营养配方在减弱餐后血糖反应方面与低碳水化合物、高脂肠内营养配方同样有效，且不会提高血浆甘油三酯反应。
