Impact of super energy-dense oral nutritional supplementation (SED ONS) on glycemic variability and food intake postoperatively in gastric cancer patients

• Published in: Surgery today (Tokyo, Japan) Vol. 53; no. 5; pp. 605 - 613
• Main Authors: Yamazaki, Ryoto, Hatao, Fumihiko, Itokawa, Masanari, Morikawa, Yoshihiko, Honda, Masataka, Imamura, Kazuhiro, Ishibashi, Yuji, Furuta, Ryuichiro, Morita, Yasuhiro
• Format: Journal Article
• Language: English
• Published: Singapore Springer Nature Singapore 01.05.2023
• Subjects: Blood Glucose; Blood Glucose Self-Monitoring - adverse effects; Dietary Supplements; Eating; Humans; Hypoglycemia; Malnutrition - etiology; Medicine; Medicine & Public Health; Original Article; Stomach Neoplasms - complications; Stomach Neoplasms - surgery; Surgery; Surgical Oncology; Continuous glucose monitoring; Oral nutritional supplements; Glycemic variability; Gastrectomy; Gastric cancer
• ISSN: 0941-1291; 1436-2813
• DOI: 10.1007/s00595-022-02600-w

Purpose Adherence to oral nutritional supplements (ONS) to prevent weight loss after gastrectomy is problematic. The present study evaluated the impact of super energy-dense ONS (SED ONS; 4 kcal/mL) on glycemic change and energy intake after gastrectomy. Methods Gastrectomy patients were placed on continuous glucose monitoring for a 3-day observation period after food intake had been stabilized postoperatively. In addition, they were given 0, 200, and 400 kcal/day of SED ONS on Days 1, 2, and 3, respectively. The primary outcome was the area under the curve < glucose 70 mg/dL (AUC < 70). The secondary outcomes were other indices of glucose fluctuation and the amount of food and SED ONS intake. Results Seventeen patients were enrolled. The AUC < 70 did not differ significantly with or without SED ONS over the observation period. SED ONS did not cause postprandial hypoglycemia and prevented nocturnal hypoglycemia. The mean dietary intake did not change significantly during the observation period, and the total energy intake increased significantly according to the amount of SED ONS provided. Conclusion SED ONS after gastrectomy increased the total energy intake without dietary reduction and it did not result in hypoglycemia.