To the content
4 . 2019

Effect of specialized product with modified carbohydrate profile on clinical and metabolic parameters in patients with type 2 diabetes

Abstract

Aim. To evaluate the effect of a low-calorie diet with the inclusion of a specialized product (SP) with a modified carbohydrate profile (dry instant mixture) on the glycemic and metabolic control indicators in patients with DM2.

Material and methods. The study included 30 patients with DM2 with concomitant obesity, grade 1-111, who were on oral sugar-lowering therapy. Within 2 weeks, patients of the main group received a low- calorie diet (1550 kcal/day) with the inclusion of SP with a modified carbohydrate profile (based on maltitol and with sweeteners) with strawberry flavor in the form of a drink (30 g dry mix per 150 ml of water) for the second breakfast instead of a carbohydrate-containing dish, which provided the intake of 7.8 g of protein, 6.1 g of fat, 1.8 g of carbohydrates, 5.6 g of maltitol. The comparison group received a low-calorie diet (1550 kcal/day) without the inclusion of SP. 1n all patients, on the background of complex therapy, anthropometric indices, body composition, parameters of carbohydrate, lipid and protein metabolism, liver function, and lipid peroxidation were assessed.

Results and discussion. 1t was shown that SP inclusion into the hypocaloric diet was accompanied by a significant decrease in the level of basal glycemia by an average of 17.4% from the initial level (p<0.05), serum total cholesterol (TC) and low density lipoproteins cholesterol (LDL-C) on average by 26.9 and 36.2% of baseline, respectively, p<0.05, while in patients of the comparison group, the change in fasting blood glucose was not statistically significant (a decrease of 8.1%), and the decrease in TC and LDL-C was on average 22.1 and 21.0%, respectively (p<0.05). At the same time, against the background of complex therapy, positive dynamic in lipid peroxidation in the main group was observed: the level of blood serum malondialdehyde decreased on average by 25.3% from the baseline values (p<0.05).

Conclusion. The inclusion of SP with a modified carbohydrate profile in a low-calorie diet is accompanied by an improvement in glycemic control, lipid metabolism and antioxidant status of patients with DM2, helping to reduce the risk of developing systemic vascular complications in this disease.

Keywords:low-calorie diet, obesity, type 2 diabetes mellitus, specialized products

For citation: Sharafetdinov Kh.Kh., Plotnikova O.A., Nazarova A.M., Kondratyeva O.V., Frolova Yu.V., Kochetkova A.A., Vorobyeva V.M. Effect of specialized product with modified carbohydrate profile on clinical and metabolic parameters in patients with type 2 diabetes. Voprosy pitaniia [Problems of Nutrition]. 2019; 88 (4): 88-94. doi: 10.24411/0042-8833-2019-10046 (in Russian)

References

1. International Diabetes Federation. IDF Diabetes. Atlas. 8th ed. 2017.

2. Dedov 1.1., Shestakova M.V., Mayorova A.Yu. (eds). Clinical recommendations. Algorithms of Specialized Medical Care for Patients with Diabetes Mellitus. 8th ed. Sakharniy diabet [Diabetes Mellitus]. 2017; 20 (1S): 1-121. (in Russian)

3. Dedov I.I., Shestakova M.V., Galstyan G.R. The prevalence of type 2 diabetes mellitus in the adult population of Russia (NATION study). Sakharniy diabet [Diabetes Mellitus]. 2016; 19 (2): 104-12. (in Russian)

4. Evert A.B., Boucher J.L., Cypress M., et al. Nutrition recommendation for the management of adults with diabetes. Diabetes Care. 2014; 37 (suppl. 1): S120-43.

5. Wheeler M.L., Dunbar S.A., Jaacks L.M., et al. Macronutrients, Food Groups, and Eating Patterns in the Management of Diabetes. A systematic review of the literature, 2010. Diabetes Care. 2012; 35 (6): 434-445.

6. Ametov A.S. Type 2 diabetes mellitus. Problems and solutions. 2nd ed., revised and additional. Moscow: GEOTAR-Media, 2013: 1032 p. (in Russian).

7. Sharafetdinov Kh.Kh., Plotnikova O.A. Innovative approaches in the treatment of diabetes mellitus type 2: the role of a specialized product for enteral nutrition "Glucerna SR". Farmateka. Endokrinologiya [Pharmateca. Endocrinology]. 2010; 3 (197): 73-8. (in Russian)

8. Sharafetdinov Kh.Kh., Plotnikova O.A., Nazarova A.M., et al. Specialized food products with modified carbohydrate profile in the correction of metabolic disturbances in diabetes type 2 diabetes. Voprosy pitaniia [Problems of Nutrition]. 2017; 86 (6): 56-66. (in Russian)

9. Uchiyama M., Mihara M. Determination of malonaldehyde precursor in tissues by thiobarbituricacid test. Anal Biochem. 1978; 86 (1): 271-8.

10. Ametov A.S., Vladimirov Yu.A., Proskurina E.V., Prudnikova M.A. Fenofibrate clinical effectiveness in oxidative stress correction for patients with diabetic neuropathy and type 2 diabetes. Endokri-nologiya: novosti, mneniya, obuchenie [Endocrinology: News, Opinions, Training]. 2016; 1 (14): 65-72. (in Russian)

11. Hurrle S., Hsu W.H. The etiology of oxidative stress in insulin resistance. Biomed J. 2017; 40 (5): 257-2.

12. Shah M.S., Brownlee M. Molecular and cellular mechanisms of cardiovascular disorders in diabetes. Circ Res. 2016; 118 (11): 1808-29.

13. Yan L.-J. Pathogenesis of chronic hyperglycemia: from reductive stress to oxidative stress. J Diabetes Res. 2014; 2014: 137919.

14. Jafarova R.E., GaraevG.Sh., Dzhafarkuliyeva Z.S. Actions of bilberry leaf extract on the course of the pathological process of alloxan-induced diabetes mellitus. Fundamental’nye issle-dovaniya [Fundamental Researches]. 2010; (4): 36-43. (inRussian).

15. Chong M.F.-F., Macdonald R., Lovegrove J.A. Fruit polyphenols and CVD risk: a review of human intervention studies. Br J Nutr. 2010; 104 (suppl 3): S28-39.

16. Huang H.Y., Appel L.J., Croft K.D., et al. Effects of vitamin C and vitamin E on in vivo lipid peroxidation: results of a randomized controlled trial. Am J Clin Nutr. 2002; 76 (3): 549-55.

17. SharafetdinovKh.Kh., Plotnikova O.A., Nazarova A.M., et al. Evaluation of the effectiveness of a specialized food product with a modified carbohydrate profile in patients with type 2 diabetes. Voprosy pitaniia [Problems of Nutrition]. 2016; 85 (6): 103-9. (in Russian)

18. Tutelyan V.A., Sharafetdinov Kh.Kh., Kochetkova A.A. Theoretical and practical aspects of dietotherapy for type 2 diabetes mellitus. Moscow: BIBLIO-GLOBUS, 2016: 244 p. (in Russian)

All articles in our journal are distributed under the Creative Commons Attribution 4.0 International License (CC BY 4.0 license)

SCImago Journal & Country Rank
Scopus CiteScore
CHIEF EDITOR
CHIEF EDITOR
Viktor A. Tutelyan
Full Member of the Russian Academy of Sciences, Doctor of Medical Sciences, Professor, Scientific Director of the Federal Research Centre of Nutrition, Biotechnology and Food Safety (Moscow, Russia)

Journals of «GEOTAR-Media»