A Diabetes-specific Oral Nutritional Supplement Improves Glycaemic Control in Type 2 Diabetes Patients.

Aims: Reducing the intake of low molecular weight carbohydrates with artificial nutrition may lower glycaemic response in patients with diabetes. We evaluated effects of a diabetes-specific carbohydrate modified oral nutritional supplement (ONS) during 12 weeks administration in 40 elderly type 2 normal weight patients with diabetes with previous involuntary weight loss.

Methods: Prospective, randomised, double-blind, controlled trial. Patients ingested 2×200 ml/day diabetes-specific or isocaloric standard ONS (control) in addition to their regular diet. Parameters of glucose and lipid metabolism, functional and nutritional status were assessed at baseline, weeks 6 and 12.

Results: Postprandial glucose incremental area under the curve (iAUC0-240 min) was comparable between treatment groups on day 1 (467.9±268.4 vs. 505.1±206.1 mmol/l*min, n.s. - arithmetic means±standard deviation) and was significantly lower with the diabetes-specific ONS vs. controls in weeks 6 and 12 (355.2±115.8 vs. 634.9±205.9 and 364.9±153.1 vs. 743.4±202.7; both P<0.0001). Postprandial peak glucose was significantly lower with the diabetes-specific ONS vs. controls in weeks 6 and 12 (P<0.0001) and the decrease in HbA1c, (baseline to week 12) was markedly pronounced (P=0.028). There were no differences between groups in insulin, HOMA-IR, lipid parameters, nutritional and performance status. Body weight and body mass index (BMI) increased significantly over time in both groups.

Conclusions: Administration of a diabetes-specific ONS for 12 weeks reduced postprandial glycaemia after ingestion of the study treatment and improved long-term glycaemic control in elderly patients with type 2 diabetes and involuntary weight loss, thereby reducing their risk for diabetes-associated long-term complications.