Effect of two carbohydrate-modified tube-feeding formulas on metabolic responses in patients with type 2 diabetes

Objectives: This study evaluated the glycemic, insulinemic, and glucagon-like peptide-1 (GLP-1) responses of subjects with type 2 diabetes mellitus to consumption of two diabetes-specific tube-feeding formulas (slowly digested carbohydrate formula [SDC] and diabetes-specific formula [DSF]) and-one formula intended for individuals without diabetes (standard formula [STND]). Methods: Forty-eight subjects controlled with diet and/or oral anti hyperglycemic medications received the SDC, DSF, and STND. Postprandial glucose, insulin, and GLP-1 were measured on three occasions after an overnight fast in a double-blinded, randomized, three-treatment, crossover design. Results: The positive area under the curve for glucose and insulin with the STND was higher (P < 0.001) compared with the SDC and DSF. The adjusted GLP-1 concentration at 60 min was higher for the SDC compared with the DSF and STND (P < 0.05). Conclusion: Both lower-carbohydrate diabetes-specific formulas resulted in a lower postprandial blood glucose response compared with the STND. The formula also rich in slowly digested carbohydrate and monounsaturated and omega-3 fatty acids (SDC) produced significantly lower blood glucose and insulin responses and higher levels of GLP-1 in the presence of significantly lower insulin concentrations. These results support the view that the quantity and quality of carbohydrate and fat may play important roles in the management of patients with type 2 diabetes mellitus and could result in improved beta-cell function over the long term. (C) 2008 Elsevier Inc. All rights reserved.