Enteral nutrition in diabetes mellitus

In the diabetic insulin deficiency gives rise to a series of special metabolic features which must be taken into consideration in artificial nutrition. Quantitative and temporal harmonization of nutrient intake and endogenous insulin reserve or exogenous insulin administration is more important than the ratio of nutrients. In critical situations, parenteral administration of insulin is to be recommended for specific modulation. If absorption of insulin from the subcutaneous tissue and of nutrients from the intestine is certain, the enteral route is feasible. Continuous nutrient provision via a pump is to be recommended, since blood glucose peaks can be avoided in this way. However, since the comparison of liquid diets with conventional food showed similar postprandial blood glucose profiles, we also regard a bolus application and a conventional subcutaneous insulin treatment regime possible in diabetes mellitus. With newly developed fiber-enriched diets, more favourable effects on metabolism may be achieved in the future.