Indian Journal of Critical Care Medicine

Register      Login



Volume / Issue

Online First

Related articles

VOLUME 21 , ISSUE 8 ( 2017 ) > List of Articles


Effect of fat-based versus carbohydrate-based enteral feeding on glycemic control in critically ill patients: A randomized clinical trial

Mahdieh Nourmohammadi, Omid Moghadam, Mohammad Lahiji, Sevak Hatamian, Zahra Shariatpanahi

Keywords : Enteral nutrition, hyperglycemia, nutrition support, olive

Citation Information : Nourmohammadi M, Moghadam O, Lahiji M, Hatamian S, Shariatpanahi Z. Effect of fat-based versus carbohydrate-based enteral feeding on glycemic control in critically ill patients: A randomized clinical trial. Indian J Crit Care Med 2017; 21 (8):500-505.

DOI: 10.4103/ijccm.IJCCM_118_17

License: CC BY-ND 3.0

Published Online: 01-07-2018

Copyright Statement:  Copyright © 2017; The Author(s).


Background and Aims: The aim of this study was to evaluate the preventive effects of high-fat enteral feeding on glycemic control and clinical outcomes in critically ill patients: a randomized clinical trial. Materials and Methods: This study was done on 42 normoglycemic patients admitted to Intensive Care Unit (ICU). Patients were randomly classified into three groups of 14 each. Control group (A) received carbohydrate-based diet (protein: 20%, fat: 30%, and carbohydrate: 50%), study groups received two types of high-fat diet; Group B (protein: 20%, fat: 45% including half of olive oil and half sunflower oil, and carbohydrate: 35%); and Group C (protein: 20%, fat: 45% including sunflower oil, and carbohydrate: 35%) in the first 48 h of admission. Results: Basal characteristics of participants were the same. After the feeding trial, there was no difference between the groups in mean plasma and capillary glucose levels and insulin requirements. Serum high density lipoprotein (HDL)-cholesterol level was increased significantly in Group B on day 10 compared to admission level (40.75 ± 5.58 vs. 43.56 ± 2.25, P = 0.05). We did not find any difference in organ failure involvement and mortality rate between groups. The number of ICU free days was significantly more in Group B compared to the control group (P = 0.04). Conclusion: High-fat diets have no preventive effect on stress hyperglycemia. High monounsaturated fat diet may increase serum HDL-cholesterol level and decrease the length of stay in ICU.

PDF Share
  1. McClave SA, Taylor BE, Martindale RG, Warren MM, Johnson DR, Braunschweig C, et al. Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.). JPEN J Parenter Enteral Nutr 2016;40:159-211.
  2. Guo YJ, Zhou Y, Zhang SY, Wei Q, Huang Y, Xia WQ, et al. Optimal target range for blood glucose in hyperglycaemic patients in a neurocritical care unit. Diab Vasc Dis Res 2014;11:352-8.
  3. Chase JG, Pretty CG, Pfeifer L, Shaw GM, Preiser JC, Le Compte AJ, et al. Organ failure and tight glycemic control in the SPRINT study. Crit Care 2010;14:R154.
  4. Parsons P, Watkinson P. Blood glucose control in critical care patients – A review of the literature. Nurs Crit Care 2007;12:202-10.
  5. Wagstaff AE, Cheung NW. Diabetes and hyperglycemia in the critical care setting: Has the evidence for glycemic control vanished? (Or … is going away?). Curr Diab Rep 2014;14:444.
  6. Clain J, Ramar K, Surani SR. Glucose control in critical care. World J Diabetes 2015;6:1082-91.
  7. Hise ME, Fuhrman MP. The effect of diabetes-specific enteral formulae on clinical and glycemic indicators. Pract Gastroenterol 2009;20:22-30.
  8. Elia M, Ceriello A, Laube H, Sinclair AJ, Engfer M, Stratton RJ, et al. Enteral nutritional support and use of diabetes-specific formulas for patients with diabetes: A systematic review and meta-analysis. Diabetes Care 2005;28:2267-79.
  9. Craig LD, Nicholson S, SilVerstone FA, Kennedy RD. Use of a reduced-carbohydrate, modified-fat enteral formula for improving metabolic control and clinical outcomes in long-term care residents with type 2 diabetes: Results of a pilot trial. Nutrition 1998;14:529-34.
  10. León-Sanz M, García-Luna PP, Sanz-París A, Gómez-Candela C, Casimiro C, Chamorro J, et al. Glycemic and lipid control in hospitalized type 2 diabetic patients: evaluation of 2 enteral nutrition formulas (low carbohydrate-high monounsaturated fat vs high carbohydrate). JPEN J Parenter Enteral Nutr 2005;29:21-9.
  11. Yokoyama J, Someya Y, Yoshihara R, Ishii H. Effects of high-monounsaturated fatty acid enteral formula versus high-carbohydrate enteral formula on plasma glucose concentration and insulin secretion in healthy individuals and diabetic patients. J Int Med Res 2008;36:137-46.
  12. Mesejo A, Acosta JA, Ortega C, Vila J, Fernández M, Ferreres J, et al. Comparison of a high-protein disease-specific enteral formula with a high-protein enteral formula in hyperglycemic critically ill patients. Clin Nutr 2003;22:295-305.
  13. de Azevedo JR, de Araujo LO, da Silva WS, de Azevedo RP. A carbohydrate-restrictive strategy is safer and as efficient as intensive insulin therapy in critically ill patients. J Crit Care 2010;25:84-9.
  14. Huschak G, Zur Nieden K, Hoell T, Riemann D, Mast H, Stuttmann R, et al. Olive oil based nutrition in multiple trauma patients: A pilot study. Intensive Care Med 2005;31:1202-8.
  15. Wewalka M, Drolz A, Zauner C. Influence of fat-based versus glucose-based enteral nutrition formulas on glucose homeostasis. Crit Care 2013;17 Suppl 2:P250.
  16. Mohri T, Matsuda H, Kubo N, Inadome N, Nakamori Y, Fujimi S, et al. The effect on glycemic control of a low-carbohydrate, high-fat enteral formula in critically ill patients admitted to a trauma and critical care center. Nihon Kyukyu Igakukai Zasshi 2011;22:871-7.
  17. Saleh NK, Saleh HA. Olive oil improved the impairment of in vitro insulin-stimulated glucose uptake by diaphragm in ovariectomized female wistar rats. Exp Gerontol 2010;45:964-9.
  18. Violi F, Loffredo L, Pignatelli P, Angelico F, Bartimoccia S, Nocella C, et al. Extra virgin olive oil use is associated with improved post-prandial blood glucose and LDL cholesterol in healthy subjects. Nutr Diabetes 2015;5:e172.
  19. Pohl M, Mayr P, Mertl-Roetzer M, Lauster F, Haslbeck M, Hipper B, et al. Glycemic control in patients with type 2 diabetes mellitus with a disease-specific enteral formula: Stage II of a randomized, controlled multicenter trial. JPEN J Parenter Enteral Nutr 2009;33:37-49.
  20. Garg A. High-monounsaturated-fat diets for patients with diabetes mellitus: A meta-analysis. Am J Clin Nutr 1998;67 3 Suppl: 577S-82S.
  21. Shahbazi S, Vahdat Shariatpanahi Z. Prevention of type 2 diabetes mellitus by changes in diet among subjects with abnormal glucose metabolism: a randomized clinical trial. Int J Diabetes Dev Ctries 2017. [doi: 10.1007/s13410-017-0548-3]. First Online: 2017 January 14.
  22. Najmi M, Vahdat Shariatpanahi Z, Tolouei M, Amiri Z. Effect of oral olive oil on healing of 10-20% total body surface area burn wounds in hospitalized patients. Burns 2015;41:493-6.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.