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Euglycemic diabetic ketoacidosis(euDKA)is a rare acute metabolic disorder syndrome,its characteristics include metabolic acidosis with a high anion gap,positive ketones in blood or urine,and blood glucose＜13.9 mmol/L.Due to low blood sugar level,euDKA is easy to be missed or delayed treatment in clinical work,resulting in serious consequences.In recent years,many cases of euDKA have been reported,but its inducements and pathogenesis are not fully understood.This article reviews the common inducements and pathogenesis of euDKA.
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INTRODUCTION: Excess body weight and its comorbidities represent a major public health issue. Interventions based on diet and exercise have not only been shown to promote weight loss, but also improve overall health, including cardiovascular health. OBJECTIVE: This study aimed to evaluate the effects of a 12-week hypocaloric low-carbohydrate (CHO) diet coupled with high-intensity functional training (HIFT) on the cardiometabolic risk of overweight adults. METHODS: This is a randomized controlled trial. A total of 31 overweight adults participated in this study, divided into two groups based on the dietary intervention: reduced-CHO (R-CHO, ≤130 g/day; n=15) and adequate-CHO (A-CHO, >130 g/day; n=16). The cardiometabolic risk was assessed using lipidaemic, insulinemia, and glycaemic parameters. A two-way ANOVA with Bonferroni post hoc test was utilized to evaluate the effects of the intervention. A p-value < 0.05 was considered statistically significant. RESULTS: Participants from both groups displayed decreased low-density lipoprotein, very-low-density lipoprotein, total cholesterol, and triacylglycerol concentrations, as well as the number of risk factors for the metabolic disease after 12 weeks. The high-density lipoprotein (HDL) cholesterol concentration of both groups increased after 12 weeks, however, the result of the intragroup analysis revealed that a significant increase was only observed in the participants from the A-CHO group. CONCLUSION: Reduced or adequate CHO intake was both found to be effective in reducing cardiometabolic risk. However, improvements in HDL and final cardiometabolic classification risk indicated that CHO adequacy in the diet might be a better strategy associated with caloric restriction and HIFT.
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Humans , Male , Female , Adolescent , Adult , Middle Aged , Young Adult , Exercise , Caloric Restriction , Overweight , Diet, Carbohydrate-Restricted , Cardiometabolic Risk Factors , UniversitiesABSTRACT
Objective:To compare the effects of low-carbohydrate diet (LCD) and low-fat diet (LFD) in the lifestyle intervention of non-alcoholic fatty liver disease (NAFLD) through a meta-analysis of randomized controlled trials.Methods:PubMed, Embase, Web of Science, Cochrane, CNKI and Wanfang were searched for relevant studies and study references and conference proceedings were manually searched. Two authors independently screened the items retrieved, extracted the data and assessed the quality of included studies. Meta-analysis was performed using R4.4.1 and RevMan5.4.1. Data were pooled using random-effects models and potential sources of heterogeneity were investigated using stratified meta-analysis. Funnel plots and Peters' test were used to assess publication bias.Results:Nine studies with a total of 510 participants met our inclusion criteria. Meta-analysis results showed that LCD and LFD interventions had similar effects on the reduction of intrahepatic lipid content in NAFLD patients ( SMD: -0.31,95% CI: 0.97 to 0.35, P = 0.36). There were no significant differences in changes of alanine aminotransferase ( SMD: -0.25, 95%CI: 0.91 to 0.41, P = 0.45) and aspartate aminotransferase ( SMD: -0.45, 95%CI: 1.63 to 0.72, P = 0.45) levels, either. Subgroup analyses implied that the duration of different interventions might be the cause of heterogeneity across studies. No significant publication bias was showed in the meta-analysis. Conclusion:Current evidence from randomized controlled studies does not support the superiority of LCD over LFD in the treatment of NAFLD.
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Objective To analyze the effect of 30% low-carbohydrate diet combined with intensive dietary intervention in the treatment of adult type 2 diabetes mellitus (T2DM). Methods A total of 93 adult patients with type 2 diabetes who were treated in Hengshui people's Hospital from February 2019 to September 2021 were selected as the research objects. On the basis of insulin treatment , the patients were randomly divided into two groups , namely the control group (conventional treatment). and observation group (low-carbohydrate diet combined with intensive dietary treatment). After 2 and 6 months of intervention， the differences in blood glucose， pancreatic islets , blood lipids , obesity indexes and adverse reaction rates were analyzed between the two groups. Results A total of 163 patients with type 2 diabetes were included in this study， including 83 in the control group and 80 in the observation group. Before the intervention， the indicators of blood glucose， blood lipids and insulin resistance of the two groups were balanced and comparable. After 2 months of intervention， the related indicators in the two groups were all decreased compared with those before the intervention， and the indicators such as glycosylated hemoglobin（t=9.860，P<0.001)， fasting blood glucose（t=3.552，P=0.005) and two-hour postprandial blood glucose （t=11.441，P<0.001)were observed. The decrease rate in the group was higher than that in the control group； after 6 months of intervention， the triglycerides in the two groups also showed a downward trend， and the observation group [(2.41±0.44) mmol/L] decreased the most（t=7.778，P<0.001). At the same time， after 2 months of intervention， the BMI and waist-hip circumference indexes of the two groups decreased compared with those before the intervention.And， the decrease of observation group hip circumference index [(84.19±8.26) cm] was compared with the control group [(85.92±6.81) cm] was more obvious（t=4.840，P<0.001)； after 6 months of intervention， the BMI（t=2.847，P=0.005) and hip circumference indexes （t=2.399，P=0.018)of both groups decreased significantly， and the decrease was more in the observation group . The correlation results showed that the measurement of fasting blood glucose in adults with type 2 diabetes was positively correlated with hip circumference (r=0.490，P=0.038)， and the two-hour postprandial blood glucose was also positively correlated with BMI (r=0.452，P=0.015) and hip circumference (r=0.396，P=0.020). Conclusion Low-carbohydrate diet combined with intensive dietary intervention can effectively improve blood glucose , blood lipid and insulin levels in adult patients with type 2 diabetes in the same time , which help to control the weight and contribute to the prognosis of patients.
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Low-carbohydrate diet is becoming popular recently. It requires carbohydrate intake lower than 130 g/d(or <26% of total energy intake) while fat and protein intake are not defined. Low-carbohydrate diet contributes to better glycemic control in patients with type 1 diabetes: lowering HbA 1C and glycemic variability, and improving time in range(TIR). Low-carbohydrate diet reduces insulin dosage in type 1 diabetic patients and does not increase the risks of hypoglycemia and diabetic ketoacidosis. This review summarized the research evidence of low-carbohydrate diet to explore the role and safety in disease management.
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Objective@#To explore the association between dietary patterns during pregnancy and the development of gestational diabetes mellitus (GDM), so as to provide the guidance of diet balance and GDM prevention for pregnant women.@*Methods@#Pregnant women who underwent prenatal examination at the First Affiliated Hospital of Xinjiang Medical University from December 2021 to July 2022 were selected as the subjects. The oral glucose tolerance test (OGTT) was employed at 24 to 28 weeks of gestation to diagnose GDM. The questionnaire of "The Survey on Nutrition and Health of Pregnant Women in China" was used to collect general information, food intake frequency and amount during a month before OGTT. Dietary patterns were determined by factor analysis, and the association between dietary patterns and the development of GDM was identified using a multivariable logistic regression model. @*Results@#Totally 449 pregnant women were included, with a median (interquartile range) age of 31.00 (5.00) years and a median (interquartile range) gestational age of 35.00 (3.00) weeks. There were 7 dietary patterns named potato-cereal pattern, poultry-meat-dessert pattern, milk-egg-aquatic product pattern, mushroom-vegetable-offal pattern, fruit-bean pattern, pickle-wheaten food pattern, and beverage-nut pattern according to the food types with high factor loads. There were 89 cases diagnosed as GDM, with a prevalence rate of 19.82%. Multivariable logistic regression analysis showed that the development of GDM was associated with the poultry-meat-dessert pattern (OR=0.242, 95%CI: 0.086-0.678) and the fruit-bean pattern (OR=0.093, 95%CI: 0.025-0.342), compared with the potato-cereal pattern. @*Conclusion@#Compared to the potato-cereal pattern, the poultry-meat-dessert pattern and the fruit-bean pattern may reduce the risk of GDM. Key words： gestational diabetes mellitus dietary pattern pregnant woman low carbohydrate diet
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@#Obesity is a complex and chronic condition that requires continuing care. A variety of diet plans are available for use in the clinical setting. Exactly what type of diet may be most beneficial remains controversial. Numerous clinical trials have been carried out over the years comparing an array of dietary interventions for weight loss, including calorie restriction diets, altered macronutrient composition diets or specific dietary patterns. This paper will provide an overview of the evidence-based dietary interventions for clinical practice.
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Lifestyle interventions, including dietary adjustments and exercise, are important for obesity management. This study enrolled adults with overweight or obesity to explore whether either low-carbohydrate diet (LCD) or exercise is more effective in metabolism improvement. Forty-five eligible subjects were randomly divided into an LCD group (n = 22) and an exercise group (EX, n = 23). The subjects either adopted LCD (carbohydrate intake < 50 g/day) or performed moderate-to-vigorous exercise (⩾ 30 min/day) for 3 weeks. After the interventions, LCD led to a larger weight loss than EX ( - 3.56 ± 0.37 kg vs. - 1.24 ± 0.39 kg, P < 0.001), as well as a larger reduction in fat mass ( - 2.10 ± 0.18 kg vs. - 1.25 ± 0.24 kg, P = 0.007) and waist circumference ( - 5.25 ± 0.52 cm vs. - 3.45 ± 0.38 cm, P = 0.008). Both interventions reduced visceral and subcutaneous fat and improved liver steatosis and insulin resistance. Triglycerides decreased in both two groups, whereas low-density lipoprotein cholesterol increased in the LCD group but decreased in the EX group. Various glycemic parameters, including serum glycated albumin, mean sensor glucose, coefficient of variability (CV), and largest amplitude of glycemic excursions, substantially declined in the LCD group. Only CV slightly decreased after exercise. This pilot study suggested that the effects of LCD and exercise are similar in alleviating liver steatosis and insulin resistance. Compared with exercise, LCD might be more efficient for weight loss and glucose homeostasis in people with obesity.
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Adult , Humans , Blood Glucose , Diet, Carbohydrate-Restricted , Homeostasis , Pilot Projects , Weight LossABSTRACT
@#Overweight and obesity are main risk factors for chronic metabolic diseases, and are strongly associated with the increased risk of premature death. Low carbohydrate diet (LCD) has been proven to effectively control body weight and fat mass in overweight and obese patients by short-term (≤6 months) dietary intervention studies. The mechanisms include regulation of energy metabolism, anti-inflammatory, antioxidant, alteration in expression of lipid metabolic-related genes and modulation of intestinal flora. However, the conclusions are inconsistent on whether LCD can cause durable weight loss and reduce the risk of overweight and obesity. This review summarizes the current research progress on the mechanisms, epidemiological studies, intervention studies and potential risks of LCD in controlling overweight and obesity, providing a reference for the future research and clinical application.
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O objetivo do presente estudo foi avaliar, por meio de uma revisão da literatura, evidências da utilização de dietas com restrição de carboidratos no manejo do diabetes mellitus (DM). As buscas eletrônicas e manuais foram até abril de 2019, e incluíram trabalhos publicados a partir de 2008. Foram excluídos estudos de pesquisas in vitro e em animais, revisões de literatura, livros, monografias, dissertações, teses, estudos de caso e relatos de caso. Os artigos remanescentes foram submetidos à análise de sua qualidade metodológica pela Escala JADAD cinco pontos. Um total de 19 estudos randomizados e com qualidade média de três pontos foram selecionados e analisados quanto aos tipos de dieta utilizadas, adesão, tipo de DM, tempo de intervenção, consumo reportado de carboidratos e resultados observados para os grupos controle e intervenção. Dentre os parâmetros escolhidos para mensurar os possíveis efeitos das dietas, destacaram-se alteração de peso e IMC, Hb1Ac, variabilidade ou controle glicêmico, perfil lipídico e alteração nas doses de insulina ou medicação utilizadas. Em quatro estudos não foram observadas vantagens significativas de uma dieta restrita em carboidratos, e 15 trabalhos relataram melhoras em um ou mais parâmetros. Tais resultados podem representar uma grande vantagem na adoção desta estratégia alimentar no manejo do DM e na prevenção de complicações da doença. Contudo, existem limitações nos estudos, que precisam ter suas hipóteses verificadas no longo prazo, e pesquisas adicionais devem ser realizadas para configurar uma estratégia oficial no controle do DM. (AU)
This study aimed to evaluate, through a literature review, evidence of the use of diets with carbohydrate restriction in the management of diabetes mellitus (DM). Electronic and manual searches were conducted until April 2019, including works published from 2008 onwards. Studies on in vitro and animal research, literature reviews, books, monographs, dissertations, theses, case studies and case reports were excluded. The remaining articles were submitted to analysis of their methodological quality by the five-point JADAD Scale. Nineteen randomized studies with an average quality of three points were selected and analyzed regarding the types of diet used, adherence, type of DM, time of intervention, reported consumption of carbohydrates and results observed for the control and intervention group. Among the parameters chosen to measure the possible effects of diets, weight and BMI changes, Hb1Ac, variability or glycemic control, lipid profile and changes in insulin doses or medication used stood out. In four studies, no significant advantages were observed from a carbohydraterestricted diet, and 15 studies reported improvements in one or more parameters. Such results can represent a great advantage in adopting this dietary strategy in the management of DM and in preventing complications of the disease. However, there are limitations in the studies, which need to have their hypotheses verified in the long term, and additional research must be carried out to configure an official strategy in the control of DM. (AU)
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Carbohydrates , Diabetes Mellitus , Diet, High-Protein Low-Carbohydrate , Dietary Carbohydrates , Diet, Fat-Restricted , Diet Therapy , Diet, Carbohydrate-RestrictedABSTRACT
Objective:To explore the effects of low-carbohydrate diet (LCD) on body weight and glycolipid metabolism in obese rats and normal weight rats. Methods:Eighty male normal weight Sprague-Dawley rats were divided randomly into three groups, i.e., normal control diet group (CD group, n=10), LCD group (n=10) and traditional high-fat diet group (HFD group, n=60). After eight weeks, 30 obese rats were selected from HFD group. Then the obese rats were divided randomly into three groups. The feed of two groups was changed from HFD to LCD (HFD-LCD group) or CD (HFD-CD group), and the rest group was fed with HFD continuously. The experiment lasted for another eight weeks. The feed of CD group and LCD group remained unchanged. The measurement indicators included body weight, feed intake, visceral fat, and blood biochemical indexes (fasting blood glucose, triacylglycerol, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol and serum β-hydroxybutyrate concentration). Results:In normal rats, from the 6th week, the body weight of LCD group was significantly lower than that of HFD group (P0.05). But at the end of the 16th week, total cholesterol of LCD group was significantly higher than that of CD group (P=0.001) and high-density lipoprotein cholesterol was lower (P=0.021). In the obese rats, at the end of the 16th week, the body weight of HFD-LCD group was significantly lower than that of HFD group and HFD-CD group (P0.05). In the obese rats, compared with HFD group, the intervention of HFD-LCD (β=-88.56, P=0.000) and HFD-CD (β=-39.08, P=0.007) resulted in the decrease of body weight. β-hydroxybutyrate level was helpful to weight loss in the range of 1-2 times of HFD-CD group (β=-34.92, P=0.006). Conclusion:LCD may have different effects on body weight and lipid metabolism between normal weight rats and obese rats, LCD has no weight loss effect on the normal weight rats, but can increase total cholesterol; however, in obese rats LCD can reduce weight and improve the metabolism of glycolipid.
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OBJECTIVES: Reduced glucose utilization in the main parts of the brain involved in memory is a major cause of Alzheimer's disease, in which ketone bodies are used as the only and effective alternative energy source of glucose. This study examined the effects of a low-carbohydrate and high-fat (LCHF) diet supplemented with a ketogenic nutrition drink on cognitive function and physical activity in the elderly at high risk for dementia.METHODS: The participants of this study were 28 healthy elderly aged 60-91 years showing a high risk factor of dementia or whose Korean Mini-Mental State Examination (K-MMSE) score was less than 24 points. Over 3 weeks, the case group was given an LCHF diet with nutrition drinks consisting of a ketone/non-ketone ratio of 1.73:1, whereas the control group consumed well-balanced nutrition drinks while maintaining a normal diet. After 3 weeks, K-MMSE, body composition, urine ketone bodies, and physical ability were all evaluated.RESULTS: Urine ketone bodies of all case group subjects were positive, and K-MMSE score was significantly elevated in the case group only (p=0.021). Weight and BMI were elevated in the control group only (p<0.05). Grip strength was elevated in all subjects (p<0.01), and measurements of gait speed and one leg balance were improved only in the case group (p<0.05).CONCLUSIONS: We suggest that adherence to the LCHF diet supplemented with a ketogenic drink could possibly influence cognitive and physical function in the elderly with a high risk factor for dementia. Further, we confirmed the applicability of this dietary intervention in the elderly based on its lack of any side effects or changes in nutritional status.
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Aged , Humans , Alzheimer Disease , Body Composition , Brain , Cognition , Dementia , Diet , Diet, High-Fat , Gait , Glucose , Hand Strength , Ketone Bodies , Leg , Memory , Motor Activity , Nutritional Status , Risk FactorsABSTRACT
OBJECTIVES: This study was conducted to investigate the effect of a 6-week low-calorie diet (LCD) program including high protein-low carbohydrate protein bar on weight loss, blood pressure, and blood lipid profile in 40 overweight women according to dietary compliance.METHODS: Subjects were 62 healthy overweight women (BMI ≥ 23.0 or body fat percentage ≥ 28%), aged 20~59 yrs who were provided a high protein-low carbohydrate protein bar (each 35 g, 154 kcal, protein energy %: 28.6%, carbohydrate energy %: 38.7%) as part of dinner for 6 weeks. Forty subjects who completed the whole diet program were categorized into high compliance (HC) group (days of eating protein bar ≥ 5 weeks) or low compliance (LC) group (days < 5 weeks).RESULTS: Energy intake significantly decreased from 1,867.5 kcal at baseline to 1,137.4 kcal at 6 weeks for the HC group and from 1,971.7 kcal to 1,362.2 kcal for the LC group, respectively. On the other hand, a significant increase in protein energy percentage was observed in each group (HC group: 3.5%, LC group: 2.2%). Both groups showed significant decreases in weight (HC group: 1.8 kg, LC group: 1.1 kg), BMI, fat mass, systolic blood pressure, total cholesterol, and LDL-cholesterol. Reduction of body fat percentage and diastolic blood pressure were only observed in the HC group.CONCLUSIONS: The inclusion of a high protein-low carbohydrate protein bar as part of a low-calorie diet for a short period can be effective to achieve weight loss and concomitantly improve blood cholesterol level without serious physiological side effects. More evident results can be achieved by eating a diet with low calorie diet including high protein-low carbohydrate protein bar for more than 5 weeks.
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Female , Humans , Adipose Tissue , Blood Pressure , Caloric Restriction , Cholesterol , Compliance , Diet , Eating , Energy Intake , Hand , Meals , Overweight , Weight LossABSTRACT
We clarify the effect of combination of low-carbohydrate diet and resistance exercise training on physical characteristics and plasma concentrations of metabolites and hormones in humans. Intervention of low-carbohydrate diet and resistance exercise training were performed on 7 healthy men and 3 women (age 39.6 ± 7.0 year; BMI 25.1 ± 3.6 kg/m2) for 8 - 12 weeks. Physical characteristics and 106 test items including and blood concentrations of metabolites and hormones were measured before and after the intervention. The effects of intervention were analyzed by a paired t-test, in which multiple testing was corrected by the method of Storey (significant variation q <0.1). In both men and women, carbohydrate and energy intake per day were low, and protein intake per day was almost the same as the recommended dietary allowance. Because carbohydrate intake were limited (174 kcal), resulting in reduction of total energy (1186 kcal). After the intervention, body weight, BMI (Body Mass Index), fat mass, body fat, muscle mass and body water content significantly decreased, while muscle mass per body mass significantly increased. Glycine, 3-methyl histidine, inorganic phosphorous, urea nitrogen, urea nitrogen per creatinine, were significantly increased, while HbA1c, white blood cell count, β-aminoisobutyric acid, adrenalin, free T4, blood ammonia, γGTP, cholinesterase, and leptin were decreased.
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Objective To observe the improvement of weight rebound in obese type 2 diabetes mellitus patients who underwent metabolic surgery after low-carbohydrate diet intervention.Methods 38 patients with obese type 2 diabetes mellitus who had underwent metabolic surgery in Changhai Hospital from Jan.2010 to Nov.2015,were randomly divided into two groups and intervened by low carbohydrate (LC) diet or diabetes mellitus (DM) diet.The blood glucose and body weight of the two groups were compared and analyzed.Results There was no statistical difference in fasting blood glucose,HbA1c,fasting C-peptide,body weight,waistline and BMI value(t=0.34,S=1.00-32.5,P＞0.05)in diabetes mellitus diet intervention group;while there was significant statistical difference in fasting blood glucose,body weight,waistline and BMI (t=2.38,S=17-24.5,P＜0.05)in low-carbo hydrate diet intervention group.There was significant differences in body weight difference (Z=2.31,P＜0.05),BMI difference(Z=2.36,P＜0.05),and weight rebound rate(P＜0.05) between the two groups,with the low carbohydrate diet intervention group displaying advantages.Conclusions Low carbohydrate diet intervention can improve fasting blood glucose,obesity indexes in obese type 2 diabetes mellitus patients who underwent metabolic surgery.Compared with diabetes mellitus diet intervention,low carbohydrate diet intervention can more greatly improve weight,weight rebound rate,rebound scale and have more advantages for maintaining the operation effects.
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Obesity has now become a huge public health issue not only in the developed world but also in developing countries. In view of the health hazards associated with obesity and more importantly for cosmetic reasons, many people, particularly the youth, have started resorting to 'extreme' weight-loss diets to achieve a rapid reduction in weight. These extreme diets are either very low in carbohydrate or very low in fat. Such extreme diets not only make the diet unbalanced but also have safety issues. Moreover, these are not sustainable in the long run. The weight that is lost is regained within a short period of time when people go off these extreme diets. This explains why the popularity of most extreme diets peaks as well as wanes rapidly. Instead of resorting to such extreme diets, correction of obesity is best achieved with balanced, healthy, nutritious diets which are low in calories, combined with adequate physical activity (exercise). Motivational counselling can also help people to initiate weight loss and sustain this weight loss over longer periods of time.
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Objective To observe the clinical effect of high fat and low carbohydrate enteral nutrition (EN) for treatment of patients with chronic obstructive pulmonary disease (COPD) under mechanical ventilation (MV). Methods Fifty-six COPD patients with MV admitted to the Department of Intensive Care Unit of Traditional Chinese Medicine Hospital of Zhuji from May 2014 to July 2017 were enrolled, and they were randomly divided into an experimental group administered with high fat and low carbohydrate EN (28 cases) and a control group administered with high carbohydrate and low fat EN (28 cases ), the therapeutic course being two weeks in both groups. After two weeks of treatment, the pH value, arterial partial pressure of carbon dioxide (PaCO2), arterial partial pressure of oxygen (PaO2), every minute ventilation volume (VE), oxygen consumption volume (VO2), carbon dioxide production volume (VCO2), total peripheral blood lymphocyte count (TLC), immunoglobulins (IgA, IgG, IgM), MV time, weaning success rate and survival rate were detected and compared between the two groups. Results Two weeks after nutritional support treatment, PaCO2, PaO2, VCO2, VO2, VE, TLC were all significantly improved in experimental group compared with those in control group [PaCO2(mmHg, 1 mmHg = 0.133 kPa): 48.37±10.22 vs. 55.34±9.87, PaO2(mmHg): 73.45±14.68 vs. 67.43±7.38, VCO2(mL): 264±22 vs. 287±30, VO2(mL): 316±35 vs. 344±22, VE (L/min): 10.0±1.6 vs. 11.6±1.9, TLC (×109/L): 1.62±0.73 vs. 1.21±0.21, all P < 0.05], MV time was significantly shorter in experiment group than that in control group (days: 6.89±1.15 vs. 8.78±1.29), weaning success rate and survival rate were significantly higher in experiment group than those in control group [weaning success rate: 67.9% (19/28) vs. 42.9% (12/28), survival rate:89.3% (25/28) vs. 78.6% (22/28), both P < 0.05]. Conclusion High fat and low carbohydrate EN can improve the ventilation and immune indexes in COPD patients with MV, shorten the MV time and increase the weaning success rate and survival rate.
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Objective To explore the effect of low-carbohydrate/high-monounsaturated fatty acids (LC/HMD) nutrition program for patients with diabetes mellitus and stroke. Methods Thirty-seven patients with diabetes mellitus and stroke after percutaneous endoscopic gastrostomy (PEG) were enrolled in this study, and these patients were treated with liquid food nutritional support. All patients were given high-carbohydrate (HCD) nutritional support at the first and second day and then changed to LC/HMD nutrition program. The blood glucose fluctuations were monitored by continuous glucose monitoring(CGM) system. Meanwhile the daily dose of insulin injections, glycosylated hemoglobin (HbA1c) and biochemical indicators were detected. for just admission and just give LC after/HMD nutrition program and three months later on HbA1c and blood biochemical indexes were detected. Results 3 months after LC/HMD nutrition program treatment, the levels of mean amplitude of plasma glucose excursions (MAGE), ratio of hyperglycemia to time, ratio of glycopenia to time, HbA1c, daily dose of insulin injections were significantly improved compared with those at the 2nd of LC/HMD nutrition program treatment and with HCD nutritional support (P < 0.05). Three months after LC/HMD nutrition program treatment, the levels of blood biochemistry index had no significant change (P > 0.05). Three months after LC/HMD nutrition program treatment, the blood glucose fluctuations significantly reduced in all patients. Conclusions For patients with diabetes mellitus and stroke and receiving liquid food treament, LC/HMD nutrition program can significantly improve glycemic index, reduce dependence on insulin, and lower blood sugar fluctuations.
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Objective To explore the effect of low-carbohydrate/high-monounsaturated fatty acids (LC/HMD) nutrition program for patients with diabetes mellitus and stroke. Methods Thirty-seven patients with diabetes mellitus and stroke after percutaneous endoscopic gastrostomy (PEG) were enrolled in this study, and these patients were treated with liquid food nutritional support. All patients were given high-carbohydrate (HCD) nutritional support at the first and second day and then changed to LC/HMD nutrition program. The blood glucose fluctuations were monitored by continuous glucose monitoring(CGM) system. Meanwhile the daily dose of insulin injections, glycosylated hemoglobin (HbA1c) and biochemical indicators were detected. for just admission and just give LC after/HMD nutrition program and three months later on HbA1c and blood biochemical indexes were detected. Results 3 months after LC/HMD nutrition program treatment, the levels of mean amplitude of plasma glucose excursions (MAGE), ratio of hyperglycemia to time, ratio of glycopenia to time, HbA1c, daily dose of insulin injections were significantly improved compared with those at the 2nd of LC/HMD nutrition program treatment and with HCD nutritional support (P < 0.05). Three months after LC/HMD nutrition program treatment, the levels of blood biochemistry index had no significant change (P > 0.05). Three months after LC/HMD nutrition program treatment, the blood glucose fluctuations significantly reduced in all patients. Conclusions For patients with diabetes mellitus and stroke and receiving liquid food treament, LC/HMD nutrition program can significantly improve glycemic index, reduce dependence on insulin, and lower blood sugar fluctuations.