A new fructose-free, resistant-starch type IV-enriched enteral formula improves glycaemic control and cardiovascular risk biomarkers when administered for six weeks to elderly diabetic patients.

BACKGROUND: Reducing the dietary glycaemic response has been proposed as a way to reduce the risk of diabetes complications. OBJECTIVE: The aim of the present study was to evaluate the glycaemic control and cardiovascular risk biomarkers in fragile, elderly type 2 diabetes patients after the intake of a new fructose-free diabetes-specific formula enriched with resistant-starch type IV and high in monounsaturated fatty acids. METHODS: Forty-one type 2 diabetes patients aged 78.9 ± 2.8 years were fed exclusively with an enteral diabetes-specific formula for 6 weeks. Data were collected at baseline and after 6 weeks of feeding. Carbohydrate and lipid metabolism and inflammatory and cardiovascular risk biomarkers were measured to evaluated the course of diabetes complications. RESULTS: Blood glycated haemoglobin significantly decreased after the intervention (6.1 ± 0.1 vs. 5.8 ± 0.1 %; p< 0,045), as well as monocyte chemotactic protein-1 and soluble E-selectin (p < 0.05), while soluble vascular cell adhesion molecule and plasminogen activator inhibitor-1 tended to decrease from baseline to 6 weeks (p = 0.084 and p = 0.05, respectively). CONCLUSION: The new product improves glycaemic control and cardiovascular risk without altering lipid metabolism, which is useful for the prevention of diabetic complications. Longer intervention studies are needed in order to validate these results in a larger population.

A new fructose-free, resistant-starch type IV-enriched enteral formula improves glycaemic control and cardiovascular risk biomarkers when administered for six weeks to elderly diabetic patients / Una nueva fórmula enteral enriquecida en almidones resistentes de tipo IV y sin fructosa mejora el control glucémico y los biomarcadores de riesgo cardiovascular cuando se administra durante seis semanas a pacientes diabéticos ancianos

Background: Reducing the dietary glycaemic response has been proposed as a way to reduce the risk of diabetes complications. Objective: The aim of the present study was to evaluate the glycaemic control and cardiovascular risk biomarkers in fragile, elderly type 2 diabetes patients after the intake of a new fructose-free diabetes-specific formula enriched with resistant-starch type IV and high in monounsaturated fatty acids. Methods: Forty-one type 2 diabetes patients aged 78.9 ± 2.8 years were fed exclusively with an enteral diabetes-specific formula for 6 weeks. Data were collected at baseline and after 6 weeks of feeding. Carbohydrate and lipid metabolism and inflammatory and cardiovascular risk biomarkers were measured to evaluated the course of diabetes complications. Results: Blood glycated haemoglobin significantly decreased after the intervention (6.1 ± 0.1 vs. 5.8 ± 0.1 %; p < 0,045), as well as monocyte chemotactic protein-1 and soluble E-selectin (p < 0.05), while soluble vascular cell adhesion molecule and plasminogen activator inhibitor-1 tended to decrease from baseline to 6 weeks (p = 0.084 and p = 0.05, respectively). Conclusion: The new product improves glycaemic control and cardiovascular risk without altering lipid metabolism, which is useful for the prevention of diabetic complications. Longer intervention studies are needed in order to validate these results in a larger population (AU)

Introducción: el control de la respuesta glucémica se ha propuesto como un mecanismo útil para reducir el riesgo de las complicaciones en los diabéticos. Objetivo: evaluar el efecto sobre el control glucémico y el riesgo cardiovascular en ancianos con diabetes de tipo 2 de una nueva fórmula específica para diabéticos, sin fructosa, y que contiene almidones resistentes de tipo IV y un elevado contenido en ácidos grasos monoinsaturados. Métodos: 41 pacientes con diabetes mellitus de tipo 2 y una edad media de 78,9 ± 2,8 años se alimentaron exclusivamente de forma enteral con la fórmula específica para diabéticos durante 6 semanas. Se tomaron muestras al inicio y al final del periodo de intervención y se determinaron biomarcadores del metabolismo de los carbohidratos y lípidos, así como de inflamación y riesgo cardiovascular, con objeto de evaluar el curso de las complicaciones de la diabetes. Resultados: la hemoglobina glicosilada en la sangre disminuyó de forma significativa tras la intervención (6,1 ± 0,1 vs. 5,8 ± 0,1 %; p < 0,045), así como la proteína quimiotáctica de monocitos-1 y la E-selectina soluble (p < 0,05), mientras que la molécula de adhesión vascular y el activador del plasminógeno-1 tendieron a disminuir tras las 6 semanas de intervención (p = 0,084 y p = 0,05, respectivamente). Conclusión: el nuevo producto mejora el control glucémico y el riesgo cardiovascular sin alterar el metabolismo lipídico, lo que resulta útil para la prevención de las complicaciones de los diabéticos. Se necesitan estudios más prolongados para confirmar este efecto en una población más amplia (AU)

Postprandial glucose, insulin and gastrointestinal hormones in healthy and diabetic subjects fed a fructose-free and resistant starch type IV-enriched enteral formula.

BACKGROUND: Reducing the dietary glycaemic response has been proposed as a means of reducing the risk of diabetes. AIM: To evaluate the effects of a new diabetes-specific formula (DSF) enriched with resistant starch type IV and fructose-free on postprandial glycaemia, insulinaemia and gastrointestinal hormones in healthy volunteers and in outpatient type 2 diabetics. METHODS: (1) Twenty-four healthy volunteers were divided into two groups: Group 1 ( n = 10) was provided 50 g of the carbohydrate (CHO) constituent of the new product and 50 g of glucose separated by 1 week; Group 2 ( n = 14) was provided 400 ml of the new DSF (T-Diet Plus(®) Diabet NP) and 400 ml of a control product separated by 1 week. (2) Ten type 2 diabetic patients received 400 ml of the new DSF and two other commercially available DSF (Glucerna(®) SR and Novasource(®) Diabet) on three occasions separated by 1 week. Venous blood samples were drawn at time 0 and at different times until 120 min. Glucose, insulin and gastrointestinal hormones were determined. Glycaemic and insulinaemic indices and glycaemic load were calculated. RESULTS: The CHO constituent and the new DSF showed low glycaemic index and glycaemic load. In healthy subjects, insulin and C-peptide release were lower after administration of the CHO constituent as well as after the new DSF (P < 0.001). Ghrelin, glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic peptide (GIP) production were lower after intake of the CHO constituent (P ranging from <0.001 to 0.019) compared with glucose, and GIP was lower after ingestion of the new DSF (P = 0.002) than after the control product. In type 2 diabetic patients, glucose AUC was lower after the administration of the new DSF (P = 0.037) compared with the others. CONCLUSIONS: Our results indicate that this new product could be beneficial for diabetic patients.