Abstract
Aims: Reducing the intake of low molecular weight carbohydrates with artificial nutrition
may lower glycaemic response in patients with diabetes. We evaluated effects of a
diabetes-specific carbohydrate modified oral nutritional supplement (ONS) during 12
weeks administration in 40 elderly type 2 normal weight patients with diabetes with
previous involuntary weight loss.
Methods: Prospective, randomised, double-blind, controlled trial. Patients ingested 2×200 ml/day
diabetes-specific or isocaloric standard ONS (control) in addition to their regular
diet. Parameters of glucose and lipid metabolism, functional and nutritional status
were assessed at baseline, weeks 6 and 12.
Results: Postprandial glucose incremental area under the curve (iAUC0-240 min) was comparable between treatment groups on day 1 (467.9±268.4 vs. 505.1±206.1 mmol/l*min,
n.s. – arithmetic means±standard deviation) and was significantly lower with the diabetes-specific
ONS vs. controls in weeks 6 and 12 (355.2±115.8 vs. 634.9±205.9 and 364.9±153.1 vs.
743.4±202.7; both P<0.0001). Postprandial peak glucose was significantly lower with
the diabetes-specific ONS vs. controls in weeks 6 and 12 (P<0.0001) and the decrease
in HbA1c, (baseline to week 12) was markedly pronounced (P=0.028). There were no differences
between groups in insulin, HOMA-IR, lipid parameters, nutritional and performance
status. Body weight and body mass index (BMI) increased significantly over time in
both groups.
Conclusions: Administration of a diabetes-specific ONS for 12 weeks reduced postprandial glycaemia
after ingestion of the study treatment and improved long-term glycaemic control in
elderly patients with type 2 diabetes and involuntary weight loss, thereby reducing
their risk for diabetes-associated long-term complications.
Key words
oral nutritional supplement - diabetes mellitus type 2 - glycaemic control
