Use of a Low-carbohydrate Enteral Nutrition Formula with Effective Inhibition of Hypoglycemia and Post-infusion Hyperglycemia in Non-diabetic Patients Fed via a Jejunostomy Tube
| Autor: | Masahide Iwashita, Teruo Maeda, Hiroo Hatakeyama, Shinji Nishiwaki, Takuya Kurobe, Atsushi Baba, Takao Hayashi, Hiroko Fujimoto |
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| Rok vydání: | 2020 |
| Předmět: |
Blood Glucose
Male medicine.medical_specialty medicine.medical_treatment Jejunostomy Nutritional Status Hypoglycemia Enteral administration Gastroenterology Enteral Nutrition Internal medicine Activities of Daily Living glycemic fluctuation Dietary Carbohydrates Internal Medicine medicine Humans Intubation Gastrointestinal Aged Monitoring Physiologic Glycemic Aged 80 and over chemistry.chemical_classification Cross-Over Studies Reactive hypoglycemia business.industry Area under the curve Fatty acid General Medicine medicine.disease carbohydrate restriction Parenteral nutrition chemistry Hyperglycemia Original Article continuous glucose monitoring Female business |
| Zdroj: | Internal Medicine |
| ISSN: | 1349-7235 0918-2918 |
| DOI: | 10.2169/internalmedicine.4465-20 |
| Popis: | Objective As direct jejunal feeding often causes great fluctuation in glucose levels, continuous or slow infusion is recommended for jejunal tube-fed patients. However, continuous feeding results in prolonged immobility and the loss of activities of daily living. We investigated whether or not intermittent feeding of a low-carbohydrate high-monounsaturated fatty acid (LC/HM) nutrient formula reduces glucose fluctuation in patients who have undergone jejunotomy. Methods Ten bed-ridden non-diabetic patients receiving enteral feeding via a jejunostomy tube were enrolled in this study. LC/HM formula and standard control formula were infused in cross-over order for each patient at a speed of 160 kcal/h. Blood glucose levels were monitored by a continuous glucose monitoring system during the investigation period. Results The mean and standard deviation of the glucose concentrations and mean amplitude of glucose excursion (MAGE) were markedly lower while receiving LC/HM formula than while receiving control standard formula (104 vs. 136 mg/dL, 18.1 vs. 58.1 mg/dL, 50.8 vs. 160 mg/dL, respectively). The post-infusion hyperglycemia [area under the curve (AUC) ＞140 mg/dL] and peak value of the glucose level were also significantly lower in patients fed LC/HM than the control (25.7 vs. 880 mg・h/dL and 153 vs. 272 mg/dL, respectively). Reactive hypoglycemia (AUC ＜70 mg/dL) was also significantly lower (0.63 vs. 16.7 mg・h/dL) and the minimum value of the glucose level higher (78.4 vs. 61.8 mg/dL) in patients fed LC/HM than the control. Conclusion The LC/HM formula is considered to markedly inhibit glycemic spikes and prevent rebound hypoglycemia in patients who receive enteral feeding after jejunostomy. |
| Databáze: | OpenAIRE |
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