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Slowly Digestible Carbohydrate Sources Can Be Used to Attenuate the Postprandial Glycemic Response to the Ingestion of Diabetes-Specific Enteral FormulasFrom the Departments of Human Biology (Dr Vanschoonbeek, Dr van Loon) and Human Movement Sciences (Mr Senden, Mr Verdijk, Dr van Loon), Nutrition and Toxicology Research Institute Maastricht (NUTRIM), Maastricht University, Maastricht, the Netherlands, and Danone Research, Centre for Specialised Nutrition, Wageningen, the Netherlands (Dr Lansink, Dr van Laere). Correspondence to L. J. C. van Loon, PhD, Department of Human Movement Sciences, Maastricht University, PO Box 616, 6200 MD Maastricht, the Netherlands, (L.vanLoon{at}HB.unimaas.nl). Purpose The purpose of this study is to compare the glycemic and insulinemic responses following the ingestion of recently developed diabetes-specific enteral formulas versus a standard and a high-fat formula. Methods Fifteen type 2 diabetes patients were selected to participate in a randomized, double-blind, crossover study. Two enteral formulas (47 energy percent [En%] carbohydrate, 34En% fat, and 4 g fiber/200 mL) were defined with either isomaltulose (formula 1) or sucromalt (formula 2) as the main carbohydrate source. For comparison, an isoenergetic diabetes-specific, high-fat (33En% carbohydrate, 50En% fat, 2.9 g fiber/200 mL) and a standard formula (55En% carbohydrate, 30En% fat, 2.8 g fiber/200 mL) were tested. Results Ingestion of formulas 1 and 2 and the high-fat formula resulted in an attenuated blood glucose response when compared with the standard formula (P < .05). In accordance, peak plasma glucose concentrations were significantly lower when compared with the standard formula (189 ± 3.6 mg/dL [10.5 ± 0.2 mmol/L], 196.2 ± 3.6 mg/dL [10.9 ± 0.2 mmol/L], 187.2 ± 3.6 mg/dL [10.4 ± 0.2 mmol/L], and 237.6 ± 3.6 mg/dL [13.2 ± 0.2 mmol/L], respectively). Plasma insulin responses were lower after consumption of the newly developed and high-fat formulas. Ingestion of the high-fat formula resulted in a greater postprandial triglyceride response (P < .05). Conclusions Diabetes-specific enteral formulas rich in slowly digestible carbohydrate sources can be equally effective in attenuating the postprandial blood glucose response as low-carbohydrate, high-fat enteral formulas without elevating the plasma triglyceride response.
This version was published on July
1, 2009 The Diabetes Educator, Vol. 35, No. 4,
631-640 (2009) |
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