Tube feeding with a diabetes-specific feed for 12 weeks improves glycaemic control in type 2 diabetes patients

Vaisman, Nachum; Lansink, Mirian; Rouws, Carlette H.; van Laere, Katrien M.; Segal, R.; Niv, Eva; Bowling, Tim E.; Waitzberg, Dan L.; Morley, John E.

doi:10.1016/j.clnu.2009.05.004

« Previous Next »Clinical Nutrition
Volume 28, Issue 5 , Pages 549-555, October 2009

Tube feeding with a diabetes-specific feed for 12 weeks improves glycaemic control in type 2 diabetes patients☆☆☆

Nachum Vaisman
- Unit of Clinical Nutrition, Tel Aviv Sourasky Medical Center, Weizmanstreet 6, Tel Aviv, Israel
- Corresponding author. Tel.: +972 3 6974807/3973; fax: +972 3 6973191/3973.
Mirian Lansink
- Danone Research-Centre for Specialised Nutrition (formerly known as Numico Research), Wageningen, The Netherlands
Carlette H. Rouws
- Danone Research-Centre for Specialised Nutrition (formerly known as Numico Research), Wageningen, The Netherlands
Katrien M. van Laere
- Danone Research-Centre for Specialised Nutrition (formerly known as Numico Research), Wageningen, The Netherlands
R. Segal
- Shmuel Harofe Hospital, Beer Yaakov, Israel
Eva Niv
- Shmuel Harofe Hospital, Beer Yaakov, Israel
Tim E. Bowling
- Division of Gastroenterology, Nottingham University Hospitals, Nottingham, United Kingdom
Dan L. Waitzberg
- Department of Gastroenterology, University of São Paulo Medical School, São Paulo, Brazil
John E. Morley
- Division of Geriatric Medicine, Saint Louis University School of Medicine and GRECC, VA Medical Center, St Louis, MO 63104, USA

Received 18 November 2008; accepted 6 May 2009. published online 15 July 2009.

Summary

Background and aims

Assess longer-term (12 weeks) effects of a diabetes-specific feed on postprandial glucose response, glycaemic control (HbA1c), lipid profile, (pre)-albumin, clinical course and tolerance in diabetic patients.

Methods

In this randomized, controlled, double-blind, parallel group study 25 type 2 diabetic patients on tube feeding were included. Patients received a soy-protein based, multi-fibre diabetes-specific feed or isocaloric, fibre-containing standard feed for 12 weeks, while continuing on their anti-diabetic medication. At the beginning, after 6 and 12 weeks, several (glycaemic) parameters were assessed.

Results

The postprandial glucose response (iAUC) to the diabetes-specific feed was lower at the 1st assessment compared with the standard feed (p=0.008) and this difference did not change over time. HbA1c decreased over time in the diabetes-specific and not in the standard feed group (treatment*time:p=0.034): 6.9±0.3% (mean±SEM) at baseline vs. 6.2±0.4% at 12 weeks in the diabetes-specific group compared to 7.9±0.3% to 8.7±0.4% in the standard feed group. No significant treatment*time effect was found for fasting glucose, insulin, (pre-) albumin or lipid profile, except for increase of HDL in the diabetes-specific group.

Conclusions

The diabetes-specific feed studied significantly improved longer-term glycaemic control in diabetic patients. This was achieved in addition to on-going anti-diabetic medication and may affect clinical outcome.

Keywords: Tube feed, HbA1c, Type 2 diabetes, Long term study, Postprandial glucose, Diabetes-specific formula

Abbreviations: ALAT, alanine aminotransferase, ASAT, aspartate aminotransferase, BUN, blood urea nitrogen, GI, gastrointestinal, HbA1c, glycosylated hemoglobin, Hs-CRP, high-sensitivity C-reactive protein, iAUC, incremental area under the curve, MUFA, monounsaturated fatty acids, NS, non-significant, (S)AE, (serious) adverse event, SEM, standard error of the mean, TG, triglycerides