Hepatic and peripheral glucose metabolism in intensive care patients receiving continuous high- or low-carbohydrate enteral nutrition

Details

Serval ID
serval:BIB_00FFDD372300
Type
Article: article from journal or magazin.
Collection
Publications
Title
Hepatic and peripheral glucose metabolism in intensive care patients receiving continuous high- or low-carbohydrate enteral nutrition
Journal
JPEN: Journal of Parenteral and Enteral Nutrition
Author(s)
Tappy  L., Berger  M., Schwarz  J. M., McCamish  M., Revelly  J. P., Schneiter  P., Jequier  E., Chiolero  R.
ISSN
0148-6071 (Print)
Publication state
Published
Issued date
10/1999
Volume
23
Number
5
Pages
260-7; discussion 267-8
Notes
Journal Article
Research Support, Non-U.S. Gov't --- Old month value: Sep-Oct
Abstract
BACKGROUND: The suppression of endogenous glucose production during parenteral nutrition is impaired in critically ill patients. It is, however, unknown whether enteral administration of carbohydrates, which normally promote hepatic glucose uptake, improves hepatic glucose metabolism in such patients. METHODS: We studied two groups of 7 patients during a 3-day continuous isocaloric enteral nutrition. A high-carbohydrate, low-lipid (EN-C) or a high-lipid, low-carbohydrate (EN-L) nutrient mixture was administered. RESULTS: Endogenous glucose production assessed with [2H7]glucose was similarly increased in both groups, indicating absence of its suppression by carbohydrate feeding. Gluconeogenesis estimated from [13C]glucose synthesis during [13C]bicarbonate infusion also was not suppressed by EN-C compared with EN-L. Systemic appearance of exogenous glucose was monitored by enteral infusion of [6,6-2H]glucose and was not different from the rate of glucose equivalent administered enterally, indicating no significant hepatic uptake of glucose in both groups. Plasma glucose and insulin concentrations were slightly higher with EN-C, although not significantly, and plasma triglycerides were similar in both groups. Both nutrition formulas were well tolerated clinically. CONCLUSIONS: These results indicate that enteral carbohydrate administration, whatever its quantity, fails to suppress endogenous glucose production and to promote net splanchnic glucose uptake in critically ill patients.
Keywords
Adult Aged Blood Glucose/metabolism Carbon Isotopes Dietary Carbohydrates/*administration & dosage Dietary Proteins/administration & dosage Energy Intake *Enteral Nutrition Female Gluconeogenesis Glucose/*metabolism Humans Insulin/blood *Intensive Care Liver/*metabolism Male Middle Aged Triglycerides/blood
Pubmed
Web of science
Create date
24/01/2008 14:36
Last modification date
03/03/2018 13:13
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