Effects of a low-carbohydrate diabetes-specific formula in type 2 diabetic patients during tube feeding evaluated by continuous glucose monitoring

summary Background & aims: In type 2 diabetic patients with dysphagia as a sequela of cerebrovascular accident, enteral nutrition tube feeding, especially with high-carbohydrate (CHO) standard formulas, may lead to acute glucose variation (GV). We assessed whether a low-CHO, diabetes-specific formula improves GV over 24 h using continuous glucose monitoring (CGM). Methods: Patients were fed either a low-CHO, diabetes-specific formula (henceforth, low-CHO formula) or a high-CHO standard formula (henceforth, high-CHO formula) for 2 days. Blood glucose (BG) was assessed by CGM throughout the observation period. Results: Ten patients who received enteral tube feeding with the low-CHO formula had significantly (p < 0.01) lower 24-h mean BG than patients fed a high-CHO formula (123.2 � 38.3 vs. 143.7 � 58.1 mg/ dL). Mean amplitude of glucose excursion was significantly (p < 0.01) lower in the low-CHO vs. high-CHO formula group, as was 24-h GV (p < 0.05). Percent period of hyperglycemia was significantly (p < 0.05) reduced when patients were fed low-CHO vs. high-CHO formula (16.8 � 31.5% vs. 37.9 � 33.0%); hypoglycemia was rarely observed. Conclusions: A low-CHO formula may enhance postprandial and fasting BG profiles and alleviate GV. It may therefore be useful for diabetic patients requiring enteral tube feeding.