ESPEN 2013 - Late breaking abstract submission

Late Breaking Abstract

ESPEN13-1818

EFFECTS OF LOW-CARBOHYDRATE ENTERAL NUTRITION ON STABILIZATION OF BLOOD SUGAR LEVELS AFTER ESOPHAGEAL SURGERY: A RANDOMIZED CONTROLLED TRIAL

T. Nakano ^1,*G. Miyata ¹T. Kamei ¹K. Naoshima ¹S. Abe ¹K. Katsura ¹Y. Taniyama ¹J. Teshima ¹N. Ohuchi ¹

¹Division of Advanced Surgical Science and Technology, Tohoku University School of Medicie, Sendai Miyagi, Japan

Rationale: Intensive insulin therapy for patients in the intensive care unit reportedly contributes to decreased complication and mortality rates. This study aimed to evaluate the effects of enteral nutrition with different lipid–carbohydrate ratios on stabilization of blood sugar levels and nitrogen balance after esophagectomy.

Methods: Forty-six patients who underwent esophagectomy for esophageal cancer were randomly assigned to receive enteral nutrition with low (LC:n = 23) or high-carbohydrate content (HC:n = 23). The primary endpoint was blood glucose levels, the amount of insulin administered, and nitrogen balance. Secondary endpoints were the incidence of complications and adverse events related to surgery and enteral nutrition.

Results: Although blood glucose levels after enteral nutrition administration and the amount of insulin administered for 7days (LC:58±60.3U, HC:104±163U) tended to be high in the high-carbohydrate group, there were no significant differences between groups. The energy administered per enteral nutrition was 39% of the total energy administered, including that from parenteral nutrition administered. Serum C-reactive protein levels were significantly low in the LC group(LC: 7.8±2.8mg/dl, HC: 10.2±4.7mg/dl).Nitrogen balance showed no significant differences between groups (LC:19.1±5.8 g/dl, HC:16.6±3.9 g/dl).

Conclusion: Low-carbohydrate enteral nutrition was safely administered without any adverse effects in this study. Of late, perioperative parenteral nutrition is being avoided; however, there were no significant differences in blood glucose levels, amount of insulin administered, and ratio of energy from enteral nutrition to that from parenteral nutrition between the two groups in this study. When the use of perioperative enteral nutrition increases, it may be safe to opt for low-carbohydrate meals in order to stabilize blood sugar levels.

Disclosure of Interest: None Declared

Keywords: insulinnitrogen balance