The use of specialised enteral formulae for patients with diabetes mellitus
The majority of enteral nutrition products for diabetes mellitus have a carbohydrate content of 30-45% and fat between 40-49%, mainly monounsaturated fat, with a mix of soluble and insoluble fibre (total of 14-24 g/l). Does this have short- and long-term benefits and which component(s) is/are crucial for the outcome or is it the combination that counts? Both manipulations of DM specific enteral formulae, i.e. addition of fibre and altered carbohydrate to fat percentage seem to be effective for short-term glucose control, but do not show convincing evidence regarding lipid management. In terms of gastro-intestinal function, there seems to be adequate evidence that fibre plays an important role for the management of diarrhoea and constipation. The implications of high fat intake on the longer-term, especially in patients suffering from gastroparesis, are less clear.