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Effects of Various Enteral Feeding Products on Postprandial Blood Glucose Response in Patients With Type I Diabetes
Author(s) -
Peters Anne L.,
Davidson Mayer B.
Publication year - 1992
Publication title -
journal of parenteral and enteral nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.935
H-Index - 98
eISSN - 1941-2444
pISSN - 0148-6071
DOI - 10.1177/014860719201600169
Subject(s) - postprandial , enteral administration , medicine , type 2 diabetes , parenteral nutrition , diabetes mellitus , gastroenterology , endocrinology
These studies were performed to evaluate the postprandial blood glucose responses to a variety of differently formulated enteral feeding products in patients with type I diabetes. Eleven subjects with type I diabetes were evaluated in three studies, all using a Biostator (artificial endocrine pancreas) that delivered a small, basal amount of insulin and measured blood glucose levels. Subjects consumed 20 mL of the assigned formula every 15 minutes for the 240 minutes of the study. Study 1 evaluated the response to each of five products: Glucerna, Enrich, Ensure HN, Pulmocare, and Compleat Modified. When the postprandial blood glucose response to Glucerna was greater than when its research formulation (EN‐8715) had been tested in 1988, studies 2 and 3 were undertaken to assess why this discrepancy occurred. Study 2 compared stored EN‐8715 to Glucerna and study 3 compared frozen and thawed vs nonfrozen EN‐8715, because of a concern that the original product had been frozen during shipping. In study 1 the glucose response (assessed as area under the glucose curve) correlated with the grams of carbohydrate present in the enteral feeding formula (r =.58, p =.002). The presence or absence of fiber, in the form of soy polysaccharide, did not affect the glucose response. Glucerna produced a significantly lower blood glucose response than did Enrich, Ensure HN, or Compleat Modified, although this response was greater than the response to EN‐8715 in 1988. However, in study 2 no differences were found between stored EN‐8715 and Glucerna and in study 3, freezing and thawing was not found to significantly alter the glucose response. Thus, the carbohydrate content of an enteral feeding formula has a significant effect on the level of the postprandial glycemic response. A low‐carbohydrate, high‐fat product, such as Glucerna, can produce an attenuated glucose response compared with products with higher carbohydrate content. However, there is a great deal of variability among individual patient responses to a given enteral feeding product, necessitating accurate blood glucose monitoring in patients fed these products, especially at the initiation of enteral feeding therapy. ( Journal of Parenteral and Enteral Nutrition 16:69–74, 1992)