Wicklmayr M, Rett K, Baldermann H, Dietze G, Mehnert H
Krankenhaus München-Schwabing, III. Medizinische Abteilung, München.
Infusionstherapie. 1989 Oct;16(5):233-6.
For total parenteral nutrition in diabetes, the same relation between carbohydrates, fat and protein of 50, 30-35 and 15-20% of total calories as in regular oral feeding has to be taken. For carbohydrates, a 2:1:1 mixture of fructose, glucose and xylitol should be used, since this is to a lesser extent blood glucose level raising as glucose alone and the dose-dependent side effects of the sugar substitutes are negligible. If insulin is infused intravenously, it is important that the carbohydrates are given simultaneously, in order to prevent deleterious hypoglycemnia. Mixtures of MCT and LCT are to be preferred towards pure LCT-emulsions, since the faster elimination of MCT/LCT-solutions may be of clinical relevance in diabetics type II, who frequently have a disturbed lipid metabolism. For protein, the normal amino acid pattern can be used, special solutions are not necessary.
