Background and objectives

Standard enteral nutrition (EN) formulas can worsen hyperglycemia in diabetic patients. We hypothesized that altering the proportion of macronutrients in a formula; increasing protein while decreasing carbohydrate concentrations would improve glycemic response. The objective of this study was to demonstrate that an EN formula containing a very high concentration of protein (in the form of whey peptides) and low concentration of carbohydrate provide better control of postprandial blood glucose relative to a very high-protein/higher-carbohydrate formula.

Subjects and methods

This was a randomized crossover clinical trial of 12 ambulatory adult subjects with type 2 diabetes. The primary outcome was glycemic response following a bolus of isocaloric amounts of two EN formulas; the secondary outcome was insulin response. Subjects were randomized to the experimental or the control formula, on two separate days, 5–7 days apart.

Results

Mean blood glucose concentrations at 10–180 min post-infusion and mean area under the curve for glucose over 240 min post-infusion were significantly lower with the experimental formula than with the control formula (71.99 ± 595.18 and 452.62 ± 351.38, respectively; p = 0.025). There were no significant differences in the mean insulin concentrations over time, insulinogenic indices, and first-phase insulin measurements.

Conclusions

An EN formula containing high-protein and low-carbohydrate loads can significantly improve glucose control in subjects with type 2 diabetes in ambulatory settings as evidenced by observed improved glucose control without significant difference in insulin response.

中文翻译：

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成人2型糖尿病患者的高蛋白低碳水化合物肠内营养配方和血浆葡萄糖控制：一项随机交叉试验

背景和目标

标准的肠内营养（EN）公式可加重糖尿病患者的高血糖症。我们假设改变配方中大量营养素的比例。增加蛋白质而降低碳水化合物浓度将改善血糖反应。这项研究的目的是证明相对于非常高的蛋白质/更高的碳水化合物，包含非常高的蛋白质（乳清肽形式）和低浓度的碳水化合物的EN配方可以更好地控制餐后血糖。公式。

主题与方法

这是一项针对12位2型糖尿病门诊成年受试者的随机交叉临床试验。主要结果是推注等量量的两个EN配方后的血糖反应。次要结果是胰岛素反应。在相隔5-7天的两天中，将受试者随机分配到实验或对照配方中。

结果

实验公式显示，输注后10–180分钟的平均血糖浓度和输注240分钟后的血糖曲线下的平均面积显着低于对照组（分别为71.99±595.18和452.62±351.38；p  = 0.025）。平均胰岛素浓度随时间，致胰岛素指数和第一阶段胰岛素测量值无显着差异。

结论

包含高蛋白和低碳水化合物负荷的EN公式可以在非卧床环境中显着改善2型糖尿病患者的血糖控制，这通过观察到改善的血糖控制而没有明显的胰岛素反应来证明。