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

Détails

ID Serval
serval:BIB_00FFDD372300
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Hepatic and peripheral glucose metabolism in intensive care patients receiving continuous high- or low-carbohydrate enteral nutrition
Périodique
JPEN: Journal of Parenteral and Enteral Nutrition
Auteur(s)
Tappy  L., Berger  M., Schwarz  J. M., McCamish  M., Revelly  J. P., Schneiter  P., Jequier  E., Chiolero  R.
ISSN
0148-6071 (Print)
Statut éditorial
Publié
Date de publication
10/1999
Volume
23
Numéro
5
Pages
260-7; discussion 267-8
Notes
Journal Article
Research Support, Non-U.S. Gov't --- Old month value: Sep-Oct
Résumé
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.
Mots-clé
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
Création de la notice
24/01/2008 14:36
Dernière modification de la notice
03/03/2018 13:13
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