Milla C, Doherty L, Raatz S, Schwarzenberg S J, Regelmann W, Moran A
Department of Pediatrics, University of Minnesota, Minneapolis 55455, USA.
JPEN J Parenter Enteral Nutr. 1996 May-Jun;20(3):182-6. doi: 10.1177/0148607196020003182.
Enteral formula feedings are frequently prescribed to cystic fibrosis (CF) patients to boost caloric intake. A substantial number of these patients are glucose intolerant and have severe respiratory compromise.
To determine the effect of the carbohydrate content on glucose tolerance and respiratory function in glucose-intolerant CF patients with poor lung function, we examined the response to bolus feedings of five dietary supplements; a high-fat formula developed in our Clinical Research Center (CRC), Pulmocare, a high-carbohydrate formula developed in our CRC, Ensure Plus, and sugar-free Scandishake.
Glucose excursion in response to the formulas with the lowest carbohydrate content was significantly less than that found in response to formulas with higher carbohydrate content. Insulin levels were also markedly lower in response to the low-carbohydrate high-fat formulas. Glucose excursion, expressed as a percent of the response to the CRC high-fat formula, was 111% +/- 12% for Pulmocare (p = NS), 202% +/- 34% for Ensure Plus (p < 01), 227% +/- 37% for CRC high carbohydrate (p = .001), and 357% +/- 33% for sugar-free Scandishake (p < .001). CO2 production, O2 consumption, minute ventilation, and respiratory rate increased modestly but not significantly in response to all formulas. No significant differences were found between the formulas in regards to these parameters. There were no subjective complaints of dyspnea during any of the five studies.
The carbohydrate content of liquid dietary supplements appears to be an important determinant of hyperglycemia in glucose-intolerant adult CF patients.
肠内配方喂养常用于囊性纤维化（CF）患者以增加热量摄入。这些患者中有相当一部分存在葡萄糖不耐受且有严重的呼吸功能损害。
为了确定碳水化合物含量对肺功能差的葡萄糖不耐受CF患者的葡萄糖耐量和呼吸功能的影响，我们检测了对五种膳食补充剂推注喂养的反应；我们临床研究中心（CRC）研发的高脂肪配方产品Pulmocare、CRC研发的高碳水化合物配方产品Ensure Plus以及无糖Scandishake。
对碳水化合物含量最低的配方的葡萄糖波动明显小于对碳水化合物含量较高的配方的葡萄糖波动。对低碳水化合物高脂肪配方的胰岛素水平也明显较低。以对CRC高脂肪配方的反应百分比表示的葡萄糖波动，Pulmocare为111%±12%（p=无显著差异），Ensure Plus为202%±34%（p<0.01），CRC高碳水化合物配方为227%±37%（p=0.001），无糖Scandishake为357%±33%（p<0.001）。对所有配方的反应中，二氧化碳产生量、氧气消耗量、分钟通气量和呼吸频率适度增加但无显著差异。在这些参数方面，各配方之间未发现显著差异。五项研究中的任何一项期间均无主观呼吸困难主诉。
液体膳食补充剂的碳水化合物含量似乎是葡萄糖不耐受成年CF患者高血糖的一个重要决定因素。
