The Effect of Diabetes-Specific Enteral Nutrition Formula on Cardiometabolic Parameters in Patients with Type 2 Diabetes: A Systematic Review and Meta–Analysis of Randomised Controlled Trials
Background: The prevalence of diabetes is on the increase in the UK and worldwide, partly due to unhealthy lifestyles, including poor dietary regimes. Patients with diabetes and other co-morbidities such as stroke, which may affect swallowing ability and lead to malnutrition, could benefit from ente...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2019-08-01
|
| Series: | Nutrients |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2072-6643/11/8/1905 |
| _version_ | 1811335041699020800 |
|---|---|
| author | Omorogieva Ojo Sharon Marie Weldon Trevor Thompson Rachel Crockett Xiao-Hua Wang |
| author_facet | Omorogieva Ojo Sharon Marie Weldon Trevor Thompson Rachel Crockett Xiao-Hua Wang |
| author_sort | Omorogieva Ojo |
| collection | DOAJ |
| description | Background: The prevalence of diabetes is on the increase in the UK and worldwide, partly due to unhealthy lifestyles, including poor dietary regimes. Patients with diabetes and other co-morbidities such as stroke, which may affect swallowing ability and lead to malnutrition, could benefit from enteral nutrition, including the standard formula (SF) and diabetes-specific formulas (DSF). However, enteral nutrition presents its challenges due to its effect on glycaemic control and lipid profile. Aim: The aim of this review was to evaluate the effectiveness of diabetes-specific enteral nutrition formula versus SF in managing cardiometabolic parameters in patients with type 2 diabetes. Method: This review was conducted in accordance with the preferred reporting items for systematic reviews and meta-analyses. Three databases (Pubmed, EMBASE, PSYCInfo) and Google scholar were searched for relevant articles from inception to 2 January 2019 based on Population, Intervention, Comparator, Outcomes and Study designs (PICOS) framework. Key words, Medical Subject Heading (MeSH) terms, and Boolean operators (AND/OR) formed part of the search strategy. Articles were evaluated for quality and risks of bias. Results: Fourteen articles were included in the systematic review and five articles were selected for the meta-analysis. Based on the findings of the review and meta-analysis, two distinct areas were evident: the effect of DSF on blood glucose parameters and the effect of DSF on lipid profile. All fourteen studies included in the systematic review showed that DSF was effective in lowering blood glucose parameters in patients with type 2 diabetes compared with SF. The results of the meta-analysis confirmed the findings of the systematic review with respect to the fasting blood glucose, which was significantly lower (<i>p</i> = 0.01) in the DSF group compared to SF, with a mean difference of −1.15 (95% CI −2.07, −0.23) and glycated haemoglobin, which was significantly lower (<i>p</i> = 0.005) in the DSF group compared to the SF group following meta-analysis and sensitivity analysis. However, in relation to the sensitivity analysis for the fasting blood glucose, differences were not significant between the two groups when some of the studies were removed. Based on the systematic review, the outcomes of the studies selected to evaluate the effect of DSF on lipid profile were variable. Following the meta-analysis, no significant differences (<i>p</i> > 0.05) were found between the DSF and SF groups with respect to total cholesterol, LDL cholesterol and triglyceride. The level of the HDL cholesterol was significantly higher (<i>p</i> = 0.04) in the DSF group compared to the SF group after the intervention, with a mean difference of 0.09 (95% CI, 0.00, 0.18), although this was not consistent based on the sensitivity analysis. The presence of low glycaemic index (GI) carbohydrate, the lower amount of carbohydrate and the higher protein, the presence of mono-unsaturated fatty acids and the different amounts and types of fibre in the DSF compared with SF may be responsible for the observed differences in cardiometabolic parameters in both groups. Conclusion: The results provide evidence to suggest that DSF is effective in controlling fasting blood glucose and glycated haemoglobin and in increasing HDL cholesterol, but has no significant effect on other lipid parameters. However, our confidence in these findings would be increased by additional data from further studies. |
| first_indexed | 2024-04-13T17:18:07Z |
| format | Article |
| id | doaj.art-0e0fd122a3cd426ca9415375f9590ebe |
| institution | Directory Open Access Journal |
| issn | 2072-6643 |
| language | English |
| last_indexed | 2024-04-13T17:18:07Z |
| publishDate | 2019-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Nutrients |
| spelling | doaj.art-0e0fd122a3cd426ca9415375f9590ebe2022-12-22T02:38:04ZengMDPI AGNutrients2072-66432019-08-01118190510.3390/nu11081905nu11081905The Effect of Diabetes-Specific Enteral Nutrition Formula on Cardiometabolic Parameters in Patients with Type 2 Diabetes: A Systematic Review and Meta–Analysis of Randomised Controlled TrialsOmorogieva Ojo0Sharon Marie Weldon1Trevor Thompson2Rachel Crockett3Xiao-Hua Wang4Department of Adult Nursing and Paramedic Science, University of Greenwich, London SE9 2UG, UKDepartment of Adult Nursing and Paramedic Science, University of Greenwich, London SE9 2UG, UKDepartment of Psychology, University of Greenwich, London SE10 9LS, UKDivision of Psychology, Faculty of Natural Sciences, University of Stirling, Scotland FK9 4LA, UKThe School of Nursing, Soochow University, Suzhou 215006, ChinaBackground: The prevalence of diabetes is on the increase in the UK and worldwide, partly due to unhealthy lifestyles, including poor dietary regimes. Patients with diabetes and other co-morbidities such as stroke, which may affect swallowing ability and lead to malnutrition, could benefit from enteral nutrition, including the standard formula (SF) and diabetes-specific formulas (DSF). However, enteral nutrition presents its challenges due to its effect on glycaemic control and lipid profile. Aim: The aim of this review was to evaluate the effectiveness of diabetes-specific enteral nutrition formula versus SF in managing cardiometabolic parameters in patients with type 2 diabetes. Method: This review was conducted in accordance with the preferred reporting items for systematic reviews and meta-analyses. Three databases (Pubmed, EMBASE, PSYCInfo) and Google scholar were searched for relevant articles from inception to 2 January 2019 based on Population, Intervention, Comparator, Outcomes and Study designs (PICOS) framework. Key words, Medical Subject Heading (MeSH) terms, and Boolean operators (AND/OR) formed part of the search strategy. Articles were evaluated for quality and risks of bias. Results: Fourteen articles were included in the systematic review and five articles were selected for the meta-analysis. Based on the findings of the review and meta-analysis, two distinct areas were evident: the effect of DSF on blood glucose parameters and the effect of DSF on lipid profile. All fourteen studies included in the systematic review showed that DSF was effective in lowering blood glucose parameters in patients with type 2 diabetes compared with SF. The results of the meta-analysis confirmed the findings of the systematic review with respect to the fasting blood glucose, which was significantly lower (<i>p</i> = 0.01) in the DSF group compared to SF, with a mean difference of −1.15 (95% CI −2.07, −0.23) and glycated haemoglobin, which was significantly lower (<i>p</i> = 0.005) in the DSF group compared to the SF group following meta-analysis and sensitivity analysis. However, in relation to the sensitivity analysis for the fasting blood glucose, differences were not significant between the two groups when some of the studies were removed. Based on the systematic review, the outcomes of the studies selected to evaluate the effect of DSF on lipid profile were variable. Following the meta-analysis, no significant differences (<i>p</i> > 0.05) were found between the DSF and SF groups with respect to total cholesterol, LDL cholesterol and triglyceride. The level of the HDL cholesterol was significantly higher (<i>p</i> = 0.04) in the DSF group compared to the SF group after the intervention, with a mean difference of 0.09 (95% CI, 0.00, 0.18), although this was not consistent based on the sensitivity analysis. The presence of low glycaemic index (GI) carbohydrate, the lower amount of carbohydrate and the higher protein, the presence of mono-unsaturated fatty acids and the different amounts and types of fibre in the DSF compared with SF may be responsible for the observed differences in cardiometabolic parameters in both groups. Conclusion: The results provide evidence to suggest that DSF is effective in controlling fasting blood glucose and glycated haemoglobin and in increasing HDL cholesterol, but has no significant effect on other lipid parameters. However, our confidence in these findings would be increased by additional data from further studies.https://www.mdpi.com/2072-6643/11/8/1905diabetes specific formulastandard formulatype 2 diabetesenteral nutritionenteral tube feedinglipidsfasting blood glucoseglycated haemoglobin |
| spellingShingle | Omorogieva Ojo Sharon Marie Weldon Trevor Thompson Rachel Crockett Xiao-Hua Wang The Effect of Diabetes-Specific Enteral Nutrition Formula on Cardiometabolic Parameters in Patients with Type 2 Diabetes: A Systematic Review and Meta–Analysis of Randomised Controlled Trials Nutrients diabetes specific formula standard formula type 2 diabetes enteral nutrition enteral tube feeding lipids fasting blood glucose glycated haemoglobin |
| title | The Effect of Diabetes-Specific Enteral Nutrition Formula on Cardiometabolic Parameters in Patients with Type 2 Diabetes: A Systematic Review and Meta–Analysis of Randomised Controlled Trials |
| title_full | The Effect of Diabetes-Specific Enteral Nutrition Formula on Cardiometabolic Parameters in Patients with Type 2 Diabetes: A Systematic Review and Meta–Analysis of Randomised Controlled Trials |
| title_fullStr | The Effect of Diabetes-Specific Enteral Nutrition Formula on Cardiometabolic Parameters in Patients with Type 2 Diabetes: A Systematic Review and Meta–Analysis of Randomised Controlled Trials |
| title_full_unstemmed | The Effect of Diabetes-Specific Enteral Nutrition Formula on Cardiometabolic Parameters in Patients with Type 2 Diabetes: A Systematic Review and Meta–Analysis of Randomised Controlled Trials |
| title_short | The Effect of Diabetes-Specific Enteral Nutrition Formula on Cardiometabolic Parameters in Patients with Type 2 Diabetes: A Systematic Review and Meta–Analysis of Randomised Controlled Trials |
| title_sort | effect of diabetes specific enteral nutrition formula on cardiometabolic parameters in patients with type 2 diabetes a systematic review and meta analysis of randomised controlled trials |
| topic | diabetes specific formula standard formula type 2 diabetes enteral nutrition enteral tube feeding lipids fasting blood glucose glycated haemoglobin |
| url | https://www.mdpi.com/2072-6643/11/8/1905 |
| work_keys_str_mv | AT omorogievaojo theeffectofdiabetesspecificenteralnutritionformulaoncardiometabolicparametersinpatientswithtype2diabetesasystematicreviewandmetaanalysisofrandomisedcontrolledtrials AT sharonmarieweldon theeffectofdiabetesspecificenteralnutritionformulaoncardiometabolicparametersinpatientswithtype2diabetesasystematicreviewandmetaanalysisofrandomisedcontrolledtrials AT trevorthompson theeffectofdiabetesspecificenteralnutritionformulaoncardiometabolicparametersinpatientswithtype2diabetesasystematicreviewandmetaanalysisofrandomisedcontrolledtrials AT rachelcrockett theeffectofdiabetesspecificenteralnutritionformulaoncardiometabolicparametersinpatientswithtype2diabetesasystematicreviewandmetaanalysisofrandomisedcontrolledtrials AT xiaohuawang theeffectofdiabetesspecificenteralnutritionformulaoncardiometabolicparametersinpatientswithtype2diabetesasystematicreviewandmetaanalysisofrandomisedcontrolledtrials AT omorogievaojo effectofdiabetesspecificenteralnutritionformulaoncardiometabolicparametersinpatientswithtype2diabetesasystematicreviewandmetaanalysisofrandomisedcontrolledtrials AT sharonmarieweldon effectofdiabetesspecificenteralnutritionformulaoncardiometabolicparametersinpatientswithtype2diabetesasystematicreviewandmetaanalysisofrandomisedcontrolledtrials AT trevorthompson effectofdiabetesspecificenteralnutritionformulaoncardiometabolicparametersinpatientswithtype2diabetesasystematicreviewandmetaanalysisofrandomisedcontrolledtrials AT rachelcrockett effectofdiabetesspecificenteralnutritionformulaoncardiometabolicparametersinpatientswithtype2diabetesasystematicreviewandmetaanalysisofrandomisedcontrolledtrials AT xiaohuawang effectofdiabetesspecificenteralnutritionformulaoncardiometabolicparametersinpatientswithtype2diabetesasystematicreviewandmetaanalysisofrandomisedcontrolledtrials |