Abstract
Rationale: Gastrostomy (GS) is the main surgical therapy for alleviating swallowing difficulty, gastroesophageal reflux, and respiratory problems in severely handicapped patients. Many of these patients may have the postprandial hyperglycemia (PH) but few are aware of it.
Methods: For a more precise validation of the PH or and hypoglycemia than that performed previously, we used continuous glucose monitoring (CGM) system for 72 successive hours. We examined 21 patients (13 men and 8 women; age, 2-19 years). We explored 3 types of therapeutic methods for PH: two diets containing slowly digested carbohydrate for controlling the glucose level, an alpha-glucosidase inhibitor, and a mixed-minced diet (MMD).
Results: Of the 21 patients, 11 showed a blood glucose level of more than 180 mg/dl during and after the intake of a conventional elemental diet (CED). And condition of 9 of the 11 PH patients was controlled by the therapeutic methods. A MMD showed lower glucose level with short infusion time compared with other meals.
Conclusion: After GS, many of the severely handicapped patients had PH. MMD may change the tolerance of glucose in diets and is one of the best therapeutic methods among diets and medication.
