Effect of two different nutritional supplements on postprandial glucose response and energy- and protein intake in hospitalised patients with COPD - A randomised cross-over study

  • Áróra Rós Ingadóttir
  • Eva Bjorg Bjorgvinsdottir
  • Anne Marie Beck
  • Christine Baldwin
  • Elizabeth Weekes
  • Olof Gudny Geirsdottir
  • Alfons Ramel
  • Bryndis Eva Birgisdottir
  • Thorarinn Gislason
  • Ingibjørg Gunnarsdottir
Beskrivelse
Introduction
Oral nutrition support is frequently used in treatment of malnutrition in patients with chronic obstructive pulmonary disease (COPD). Considering the use of corticoidsteroids in patients with COPD, little is known about the effect on postprandial glucose response and if they might interfere with glucose control. Our aims were to compare the effect of a liquid oral nutritional supplement (ONS) and semi solid inbetween meal snack (snack) on postprandial glucose and energy- and protein intake, and to compare the effect of timing of each intervention on postprandial glucose and energy- and protein intake.

Methods
Patients with COPD (n = 17) admitted to the Department of Pulmonary Medicine, Iceland and defined as at low or medium nutritional risk (score 0–3) were recruited. In a randomised cross-over design, subjects consumed ONS or snack either in a fasting state (study 1) or following breakfast (study 2) and postprandial glucose responses were assessed at regular intervals for two hours (t = 15, t = 30, t = 45, t = 60, t = 90, t = 120 min). Energy- and protein intake was estimated using a validated plate diagram sheet. Wilcoxon Signed-Rank test was used to compare the two interventions.

Results
In study 2, following breakfast, postprandial glucose was significantly higher after consuming ONS than the snack after 60 min (9.7 ± 2.4 mmol/L vs. 8.2 ± 3.2 mmol/L, p = 0.013 and 120 min 9.2 ± 3.2 mmol/L vs. 7.9 ± 2.4 mmol/L, p = 0.021, respectively). No difference was found in postprandial glucose concentrations between ONS and the snack when consumed after overnight fasting (study 1). No difference in energy or protein intake from hospital food was seen between supplement types neither in study 1 or 2.

Conclusion
Lower postprandial glucose concentrations were associated with the snack compared to ONS when taken after a meal compared to either type directly after overnight fasting. The clinical relevance of higher postprandial blood glucose after consuming a liquid ONS after breakfast compared with a semi solid snack needs to be studied further.
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Flere informationer

OriginalsprogEngelsk
TidsskriftClinical Nutrition ESPEN
Vol/bind39
Udgave nummer4
Sider (fra-til)1085–1091
Antal sider7
ISSN2405-4577
PublikationsartForskning
Peer reviewJa

Samarbejdspartnere

  • University of Iceland
  • Guy's & St Thomas' NHS Foundation Trust, London
  • Kings College London