Effects of high-protein enteral nutritional preparation on blood glucose levels in acute stroke patients with type 2 diabetes mellitus / 中华临床营养杂志

ABSTRACT

Objective:To explore the effects of diabetic enteral nutrition preparation with whey protein addition on blood glucose levels in acute stroke patients with type 2 diabetes mellitus (T2DM).Methods:A total of fifty-six acute stroke patients with T2DM were enrolled in this study from January 2020 to May 2021. These patients were randomly divided into the experimental group or the control group. Enteral nutrition were initiated within 24~48 hours after admission. Both groups were given diabetic enteral nutritional preparation while whey protein power was added at 15 g per 500 ml nutrient solution only in the experimental group. Fasting plasma glucose (FPG), 2 hour postprandial blood glucose (2h-PBG), serum albumin, lymphocyte counts, insulin dose, hypoglycemia incidence and the maximal fluctuation of blood glucose were compared between groups before and after intervention.Results:Compared with the control group, 2h-PBG [9.85 (5.9) mmol/L vs 12.95 (2.2) mmol/L, P=0.049] on Day 7 , FPG [(9.71±1.94) mmol/L vs (11.01±2.19) mmol/L, P=0.029] and 2h-PBG [(10.75±2.16) mmol/L vs (12.23±2.21) mmol/L, P=0.019] on Day 15 in experimental group were significantly decreased. The levels of serum albumin [(34.93±4.37) g/L vs (30.11±5.97) g/L, P=0.002] and lymphocyte counts [(1.12±0.50)×10 9 /L vs (0.86±0.29)×10 9 /L, P=0.025] in experimental group were increased significantly. While Insulin usage [2.5 (6) d vs 9 (11) d, P<0.001] and dose [0.06 (0.17) U/(kg·d) vs 0.19 (0.17) U/(kg·d), P=0.002] as well as maximal fluctuation of blood glucose [6.0 (2.1) mmol/L vs 8.4 (6.6) mmol/L, P=0.003] were significantly lower. Conclusion:Increasing the proportion of protein in diabetic enteral nutrition can improve serum albumin level and is beneficial to blood glucose control in acute stroke patients with T2DM, but the underlying mechanisms and effects on long-term prognosis need further exploration.