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Vol. 52. Núm. 9.
Páginas 516-524 (Noviembre 2005)
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Vol. 52. Núm. 9.
Páginas 516-524 (Noviembre 2005)
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Fórmulas de nutrición enteral para personas con diabetes mellitus
Enteral nutrition formulas in diabetes mellitus
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G. Olveira-Fustera,??
Autor para correspondencia
gabrielm.olveira.sspa@juntadeandalucia.es

Correspondencia: G. Olveira Fuster. Servicio de Endocrinología y Nutrición. Unidad de Nutrición, 4.ª planta, Pabellón A. Hospital Regional Universitario Carlos Haya. Avenida Carlos Haya, s/n. 29010 Málaga. España.
, M. Gonzalo-Marínb
a Unidad de Nutrición Clínica. Servicio de Endocrinología y Nutrición. Hospital Regional Universitario Carlos Haya. Málaga. España
b Pertenece a de la red de Centros para el estudio de las Enfermedades del Metabolismo y de la Nutrición (C03/08). Instituto de Salud Carlos III. España
Información del artículo

La diabetes mellitus es una afección crónica muy prevalente tanto en la población general como en la hospitalizada. Las indicaciones del soporte nutricional artificial en las personas con diabetes no difieren de las de las personas sin diabetes, y el número de pacientes que reciben nutrición enteral se está incrementando progresivamente en los últimos años. En el tratamiento de la diabetes, se ha demostrado que un abordaje intensive multifactorial reduce la morbimortalidad, así como los costes asociados,tanto en pacientes ambulatorios como hospitalizados. Por ello, el objetivo de control metabólico en pacientes diabéticos que reciben nutrición enteral debe ser alcanzar los requerimientos nutricionales adecuados,pero manteniendo un perfil glucémico y lipídico óptimos. En este sentido la apropiada selección de una formulación enteral puede influir sobre el control metabólico del individuo.

En los últimos años se han comercializado un gran número de formulas de nutrición enteral “diseñadas para diabetes” con el objetivo nutrir adecuadamente al paciente, pero sin empeorar (o incluso mejorar) el control metabólico (glucémico y lipídico).

En personas con diabetes o hiperglucemia de estrés, al igual que en la dieta habitual, el uso de fórmulas enterales con un contenido moderado/alto en lípidos monoinsaturados presenta un efecto favorable sobre el control metabólico a corto y medio plazo. La adición de fibra (preferentemente fermentable), el tipo de hidratos de carbono (y probablemente de proteínas) son factores coadyuvantes en la disminución de la respuesta glucémica posprandial.

No obstante, son necesarios estudios a largo plazo sobre el efecto metabólico y la morbimortalidad para poder ofrecer recomendaciones basadas en la evidencia.

Palabras clave:
Nutrición enteral
Diabetes mellitus
Índice glucémico
Carga glucémica
Ácidos grasos monoinsaturados

Diabetes mellitus is a chronic disease that is highly prevalent among both the general population and hospitalized individuals.

The indications for artificial nutritional support in diabetics do not differ from those among non-diabetics. In the last few years, the number of patients receiving enteral nutrition has progressively increased. An intensive, multifactorial approach in the treatment of diabetes has been shown to reduce morbidity and mortality, as well as associated costs, in both inpatients and outpatients. The aim of metabolic control in diabetic patients who receive enteral nutrition should be to achieve adequate nutrition while maintaining optimal lipid and glycemic profiles. In this context, the appropriate selection of enteral formula can influence metabolic control.

In the last few years a large number of enteral nutrition formulas “designed for diabetes” have become available. These formulas aim to achieve adequate nutrition but without worsening (and even improving) metabolic control (glycemic and lipidic).

In individuals with diabetes or stress hyperglycemia, as with the normal diet, the use of enteral formulas with a moderate/high monounsaturated lipid content has a favorable effect on metabolic control in the short and medium term. Addition of fiber (preferably fermentable) and the type of carbohydrates (and probably of proteins) are coadjuvant factors in reducing postprandial glycemic response.

Nevertheless, long-term studies on the effect of these formulas on metabolic control, morbidity and mortality are required before evidence-based recommendations can be made.

Key words:
Enteral nutrition
Diabetes Mellitus
Glycemic Index
Glycemic Load
Monounsaturated Fatty Acids
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