Effect of high-fat, low-carbohydrate enteral formula versus standard enteral formula in hyperglycemic critically ill patients: a randomized clinical trial

Abstract

High-fat, low-carbohydrate diets may attenuate the hyperglycemia in critically ill patients. This study was performed to compare the effects of high-fat, low-carbohydrate enteral nutrition on glycemic control and clinical outcomes in new identified hyperglycemic patients. Eighty-eight new identified hyperglycemic patients with no history of diabetes or diagnosed hyperglycemia were randomly allocated to a standard (protein 20%, fat 30%, and carbohydrate 50%) or high-fat (protein 20%, fat as equal amount of olive and sunflower 45%, and carbohydrate 35%) kitchen formulas. Duration of intervention was 15 days. Baseline characteristics of patients were the same. Forty-one patients in the high fat and 39 patients in the standard group completed the study. Mean blood glucose, mean infused insulin, final blood glucose, and final infused insulin were not differed significantly between groups. Repeated measure showed that the average blood glucose declined in the high-fat formula group, as well as standard one, but with more decline at the end of the first week, and with a higher rate in the high-fat formula group. The mean blood triglyceride level on the final day was lower in the high-fat formula group (p = 0.001). There were no significant differences between groups in clinical outcomes. Although the high-fat formula declined blood glucose and triglyceride levels more than the standard group, yet the decrease in blood glucose was not significant. Also, it has no significant effect on clinical outcomes.