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Effects of Various Enteral Feeding Products on Postprandial Blood Glucose Response in Patients With Type I Diabetes

Cedars-Sinai Medical Center and UCLA School of Medicine, Los Angeles, California

Mayer B. Davidson, MD

Cedars-Sinai Medical Center and UCLA School of Medicine, Los Angeles, California

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)

Journal of Parenteral and Enteral Nutrition, Vol. 16, No. 1, 69-74 (1992)
DOI: 10.1177/014860719201600169


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