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在连续喂养 4 小时期间,新型高蛋白糖尿病专用管饲可改善 2 型糖尿病患者的血糖谱。

Improved Glucose Profile in Patients With Type 2 Diabetes With a New, High-Protein, Diabetes-Specific Tube Feed During 4 Hours of Continuous Feeding.

机构信息

1 Nutricia Research, Nutricia Advanced Medical Nutrition, Utrecht, the Netherlands.

2 Department of Cardiovascular and Metabolic Diseases, IRCCS Gruppo Multimedica, Sesto San Giovanni (MI), Italy.

出版信息

JPEN J Parenter Enteral Nutr. 2017 Aug;41(6):968-975. doi: 10.1177/0148607115625635. Epub 2016 Jan 29.

Abstract

BACKGROUND

Hyperglycemia frequently occurs in hospitalized patients receiving nutrition support. In this study, the effects of a new diabetes-specific formula (DSF) on glucose profile during 4 hours of continuous feeding and 4 hours after stopping feeding were compared with a standard formula (SF).

MATERIALS AND METHODS

In this randomized, controlled, double-blind, crossover study, ambulant, nonhospitalized patients with type 2 diabetes received the DSF or an isocaloric, fiber-containing SF via a nasogastric tube. After overnight fasting, the formula was continuously administered to the patients during 4 hours. Plasma glucose and insulin concentrations were determined during the 4-hour period and in the subsequent 4 hours during which no formula was provided.

RESULTS

During the 4-hour feeding period, DSF compared with SF resulted in a lower mean delta glucose concentration in the 3- to 4-hour period (0.3 ± 1.0 and 2.4 ± 1.5 mmol/L; P < .001). Also, the (delta) peak concentrations, (delta) mean concentrations, and incremental area under the curve (iAUC) for glucose and insulin were significantly lower during DSF compared with SF feeding (all comparisons: P < .001). Furthermore, fewer patients experienced hyperglycemia (>10 mmol/L) on DSF compared with SF (2 vs 11, P = .003, respectively). No differences in number of patients with hypoglycemia (<3.9 mmol/L) were observed. No significant differences in tolerance were observed.

CONCLUSION

Administration of a new, high-protein DSF during 4 hours of continuous feeding resulted in lower glucose and insulin levels compared with a fiber-containing SF in ambulant, nonhospitalized patients with type 2 diabetes. These data suggest that a DSF may contribute to lower glucose levels in these patients.

摘要

背景

接受营养支持的住院患者常发生高血糖。本研究比较了一种新型糖尿病专用配方(DSF)与标准配方(SF)在连续喂养 4 小时和停止喂养 4 小时期间对血糖谱的影响。

材料和方法

本随机、对照、双盲、交叉研究纳入了 2 型糖尿病的门诊非住院患者,通过鼻胃管给予 DSF 或等热量含纤维 SF。禁食过夜后,患者连续接受配方喂养 4 小时。在 4 小时期间测定血浆葡萄糖和胰岛素浓度,并在随后的 4 小时内不提供配方时测定。

结果

在 4 小时喂养期间,与 SF 相比,DSF 使 3 至 4 小时期间的平均葡萄糖差值浓度更低(0.3±1.0 与 2.4±1.5 mmol/L;P<.001)。此外,与 SF 喂养相比,DSF 时葡萄糖和胰岛素的(Δ)峰值浓度、(Δ)平均浓度和增量曲线下面积(iAUC)均显著降低(所有比较:P<.001)。此外,与 SF 相比,DSF 时发生高血糖(>10 mmol/L)的患者更少(2 与 11 例,P=.003)。低血糖(<3.9 mmol/L)患者的数量无差异。未观察到耐受性的显著差异。

结论

与含纤维 SF 相比,在 2 型糖尿病门诊非住院患者连续喂养 4 小时给予新型高蛋白 DSF 可降低血糖和胰岛素水平。这些数据表明,DSF 可能有助于降低这些患者的血糖水平。

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