The effect of higher carbohydrate intake on plasmatic glucose levels in patients in after care

Overview

Loss of body muscle is especially common in hospitalized elderly people. At the same time, type 2 diabetes is common in these patients with a recommended reduction in dietary carbohydrate intake. However, carbohydrate intake is necessary to induce an anabolic situation and subsequent improvement of the patient‘s condition during recovery; on the other hand, it is limited in the elderly due to the fear of decompensation. The aim of our prospective study was to determine to what extent increased carbohydrate intake affects the 24-hour glycaemic profile in elderly patients with type 2 diabetes admitted to aftercare beds. Fourteen type 2 diabetic patients were enrolled in this prospective study. During the first week, they received a standard hospital diabetic diet containing 250 g of carbohydrate. In the following week, 50 g of maltodextrin was added to each main meal - the total carbohydrate intake was 400 g per day. For both weeks, patients‘ blood glucose was monitored using a subcutaneous sensor. The addition of 150 g of maltodextrin led to rises in glycaemia after its administration. This rise was most pronounced in the first half of the week (days 1 to 3). There was a decrease in glycaemia in the subsequent period. No patient required a change in diabetic treatment, nor was there any decompensation. Our study suggests that carbohydrate restriction should be re-evaluated, especially in the elderly who need nutritional support.

Keywords:

geriatric patient – Carbohydrates – insulin resistance – anabolism