Clinical experience with modified enteral formulas for patients with diabetes

Standard tube-feeding formulas may not meet the specific nutritional needs of many patients with impaired glucose tolerance. In particular, standard enteral formulas often cause potentially dangerous increases in blood glucose levels. Clinical experience and studies to date have shown advantages of using disease-specific enteral formulas for these patients. Specialized formulas with increased fiber may improve glycemic control, although the concomitant increases in viscosity of these formulas may limit their usefulness for tube feeding. Glucerna, a specialized formula with low-carbohydrate, high-monounsaturated-fat content that has been enriched with a fiber source that permits tube feeding, has been shown to improve glycemic control and decrease the potential for complications. Appropriate tube feeding for patients with impaired glucose tolerance, however, extends beyond formula composition. Patients also require ongoing blood glucose monitoring, evaluation of gastric motility, and assessment of overall health and nutritional status.