Different enteral nutrition formulas have no effect on glucose homeostasis but on diet-induced thermogenesis in critically ill medical patients: a randomized controlled trial

Hyperglycemia is common in critically ill patients and associated with increased mortality. It has been suggested that different nutrition formulas may beneficially influence glucose levels in surgical intensive care patients. In this prospective randomized clinical cohort study we investigated gluc...

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Bibliographic Details
Published in:European journal of clinical nutrition 2018-04, Vol.72 (4), p.496-503
Main Authors: Wewalka, Marlene, Drolz, Andreas, Seeland, Berit, Schneeweiss, Mathias, Schmid, Monika, Schneeweiss, Bruno, Zauner, Christian
Format: Article
Language:English
Subjects:
Adult
Aged
Blood Glucose - physiology
Calorimetry
Critical Illness - epidemiology
Critical Illness - therapy
Demand
Diet
Energy demand
Energy expenditure
Enteral nutrition
Enteral Nutrition - adverse effects
Enteral Nutrition - methods
Enteral Nutrition - statistics & numerical data
Female
Food, Formulated - adverse effects
Food, Formulated - statistics & numerical data
Glucose
Homeostasis
Hospitalization
Humans
Hyperglycemia
Insulin
Male
Middle Aged
Nutrition
Nutrition research
Nutritional Status
Patients
Prospective Studies
Randomization
Substrates
Surgery
Thermogenesis
Thermogenesis - physiology
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Summary:Hyperglycemia is common in critically ill patients and associated with increased mortality. It has been suggested that different nutrition formulas may beneficially influence glucose levels in surgical intensive care patients. In this prospective randomized clinical cohort study we investigated glucose homeostasis in response to different enteral nutrition formulas in medical critically ill patients. 60 medical critically ill patients were randomized to receive continuous fat-based (group A, n = 30) or glucose-based enteral nutrition (group B, n = 30) for seven days. Indirect calorimetry was performed to determine energy demand at baseline and on days 3 and 7. Glucose levels and area under the curve (AUC), insulin demand, glucose variability, and calorie and substrate intake per 24 h were assessed for 7 days. Over the course of 7 days patients had similar average daily glucose (p = 0.655), glucose AUC (A: 758 (641-829) mg/dl/day vs B: 780 (733-845) mg/dl/day, p = 0.283), similar overall insulin demand (A: 153.5 (45.3-281.5) IE vs B: 167.9 (82.3-283.8) IE, p = 0.525), and received similar amounts of enteral nutrition per 24 h. Resting energy expenditure was similar at baseline (A: 1556 (1227-1808) kcal/day vs B: 1563 (1306-1789) kcal/day, p = 0.882) but energy expenditure increased substantially over time in group A (p 
ISSN:0954-3007
1476-5640
DOI:10.1038/s41430-018-0111-4