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Glycemic and Lipid Control in Hospitalized Type 2 Diabetic Patients: Evaluation of 2 Enteral Nutrition Formulas (Low Carbohydrate-High Monounsaturated Fat vs High Carbohydrate)

Miguel León-Sanz, MD, PhD^*, Pedro P. García-Luna, MD, PhD, Mercé Planas, MD, PhD, Alejandro Sanz-París, MD, PhD, Carmen Gómez-Candela, MD, PhD^||, César Casimiro, MD^¶ and the Abbott SPAI-97–004 Study Cooperative Group

From the ^* Hospital 12 de Octubre, Madrid, Spain; Hospital Virgen del Rocío, Sevilla, Spain; Hospital Vall D' Hebrón, Barcelona, Spain; Hospital Miguel Servet, Zaragoza, Spain; ^|| Hospital La Paz, Madrid, Spain; and ^¶ Abbott Laboratories, Madrid, Spain

Correspondence: M. León-Sanz, MD, PhD, Unidad de Nutrición Clínica, Hospital Universitario 12 de Octubre, Av de Córdoba s/n, 28041 Madrid, Spain. Electronic mail may be sent to mleon{at}h12o.es.

Background: Type 2 diabetic patients may need enteral nutrition support as part of their treatment. The objective was to compare glycemic and lipid control in hospitalized patients with type 2 diabetes requiring feeding via nasogastric tube using enteral feedings with either a high-carbohydrate or a high-monounsaturated-fat content. Methods: This trial included type 2 diabetes patients admitted to the hospital for neurologic disorders or head and neck cancer surgery who received either a low-carbohydrate–high-monounsaturated-fat (Glucerna) or a high-carbohydrate diet (Precitene Diabet). Glycemic and lipid control was determined weekly. Safety and gastrointestinal tolerance were also assessed. Results: A total of 104 patients were randomized and 63 were evaluable according to preestablished protocol criteria. Median duration of therapy was 13 days in both groups. Mean glucose was significantly increased at 7 days of treatment (p = .006) in the Precitene arm, with no significant variations in the Glucerna arm. Mean weekly blood triglycerides levels in the Precitene arm were increased without reaching statistical significance, whereas patients in the Glucerna arm showed a stable trend. Patients in the Precitene arm showed a significantly higher incidence of diarrhea than patients in Glucerna arm (p = .008), whereas the incidence of nausea was smaller in the Precitene arm than in the Glucerna arm (p = .03). Conclusions: An enteral formula with lower carbohydrate and higher monounsaturated fat (Glucerna) has a neutral effect on glycemic control and lipid metabolism in type 2 diabetic patients compared with a high-carbohydrate and a lower-fat formula (Precitene Diabet).

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