{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T21:28:44Z","timestamp":1779312524334,"version":"3.51.4"},"reference-count":28,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,5,30]],"date-time":"2024-05-30T00:00:00Z","timestamp":1717027200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,5,30]],"date-time":"2024-05-30T00:00:00Z","timestamp":1717027200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Nutr. Diabetes"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background\/objectives<\/jats:title>\n                <jats:p>In patients with acute stroke, the presence of hyperglycaemia has been associated with higher morbidity and less neurological recovery. The aim of the study was to evaluate the impact of a diabetes specific enteral nutrition (EN) formula on glycaemia, comorbidities and mortality in patients admitted with a first episode of stroke who received complete EN.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>This was a prospective randomised controlled trial. Patients with acute stroke did not have diagnosis of diabetes mellitus and required nasogastric tube feeding. This study has been registered with code NCT03422900. The patients were randomised into two arms: an isocaloric isoprotein formula (control group (CG), 27 patients) vs a diabetes-specific formula (low glycaemic index carbohydrates, fibre (80% soluble) and higher lipid content) (experimental group (EG), 25 patients). Pre-EN blood glucose, hyperglycaemia during EN treatment, HbA1c, insulin use, oral route recovery, length of stay (LOS) and mortality at 30\u2009days were collected. The complications of enteral nutrition during admission were collected as well.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>52 patients were included, 50% females, with an age of 77.44(11.48)\u2009years; 34 (65.4%) had ischaemic stroke, with a Rankin score of 0(0\u20132), and a National Institute of Health Stroke Scale (NIHSS) of 19 (15\u201322). In CG, there were more cases of hyperglycaemia on the 5th day post-NE (13(65%) vs7(35%), <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01). CG showed an OR of 7.58(1.49\u201339.16) (<jats:italic>p<\/jats:italic>\u2009=\u20090.02) for the development of hyperglycaemia. There were no differences in LOS between groups (12(8.5)\u2009days vs 14(23)\u2009days, <jats:italic>p<\/jats:italic>\u2009=\u20090.19) or in the death rate (10(37%) vs 10(40%), <jats:italic>p<\/jats:italic>\u2009=\u20090.8), although differences were found in terms of oral route recovery (EG: 11(44%) patients vs CG: 5(18.5%) patients, <jats:italic>p<\/jats:italic>\u2009=\u20090.04) (OR (EG): 5.53(1.25\u201324.47); <jats:italic>p<\/jats:italic>\u2009=\u20090.02).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>The use of a diabetes-specific enteral formula in non-diabetic patients admitted with acute stroke reduced the risk of developing hyperglycaemia and improved the rate of oral route recovery.<\/jats:p>\n                <jats:p>Registered under ClinicalTrials.gov Identifier no. NCT03422900.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1038\/s41387-024-00292-4","type":"journal-article","created":{"date-parts":[[2024,5,30]],"date-time":"2024-05-30T10:37:01Z","timestamp":1717065421000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Effect of a diabetes-specific formula in non-diabetic inpatients with stroke: a randomized controlled trial"],"prefix":"10.1038","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3144-343X","authenticated-orcid":false,"given":"Juan J.","family":"L\u00f3pez-G\u00f3mez","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Esther","family":"Delgado Garc\u00eda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Primo-Mart\u00edn","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M\u00f3nica","family":"Sim\u00f3n de la Fuente","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emilia","family":"G\u00f3mez-Hoyos","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebeca","family":"Jim\u00e9nez-Sahag\u00fan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beatriz","family":"Torres-Torres","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana","family":"Ortol\u00e1-Buigues","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beatriz","family":"G\u00f3mez-Vicente","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan F.","family":"Arenillas-Lara","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1745-9315","authenticated-orcid":false,"given":"Daniel A.","family":"De Luis Rom\u00e1n","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,5,30]]},"reference":[{"key":"292_CR1","first-page":"321","volume":"73","author":"F Purroy","year":"2021","unstructured":"Purroy F, Montal\u00e0 N. Epidemiology of stroke in the last decade: a systematic review. Rev Neurol. 2021;73:321\u201336.","journal-title":"Rev Neurol"},{"key":"292_CR2","first-page":"30168","volume":"S0213-4853","author":"\u00c1 S\u00e1nchez-Larsen","year":"2016","unstructured":"S\u00e1nchez-Larsen \u00c1, Garc\u00eda-Garc\u00eda J, Ayo-Mart\u00edn O, Hern\u00e1ndez-Fern\u00e1ndez F, D\u00edaz-Maroto I, Fern\u00e1ndez-D\u00edaz E, et al. Has the aetiology of ischaemic stroke changed in the past decades? analysis and comparison of data from current and historical stroke databases. Neurol Barc Spain. 2016;S0213-4853:30168\u20132.","journal-title":"Neurol Barc Spain"},{"key":"292_CR3","doi-asserted-by":"publisher","first-page":"354","DOI":"10.1016\/j.clnu.2017.09.003","volume":"37","author":"R Burgos","year":"2018","unstructured":"Burgos R, Breton I, Cereda E, Desport JC, Dziewas R, Genton L, et al. ESPEN guideline clinical nutrition in neurology. Clin Nutr Edinb Scotl. 2018;37:354\u201396.","journal-title":"Clin Nutr Edinb Scotl"},{"key":"292_CR4","doi-asserted-by":"publisher","first-page":"2215","DOI":"10.1016\/S0140-6736(10)60484-9","volume":"375","author":"N Sarwar","year":"2010","unstructured":"Emerging Risk Factors Collaboration, Sarwar N, Gao P, Seshasai SRK, Gobin R, Kaptoge S, et al. Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: a collaborative meta-analysis of 102 prospective studies. Lancet Lond Engl. 2010;375:2215\u201322.","journal-title":"Lancet Lond Engl"},{"key":"292_CR5","doi-asserted-by":"publisher","first-page":"S124","DOI":"10.1016\/j.jcjd.2013.01.035","volume":"37","author":"M Sharma","year":"2013","unstructured":"Sharma M, Gubitz GJ. Management of stroke in diabetes. Can J Diabetes. 2013;37:S124\u20135.","journal-title":"Can J Diabetes"},{"key":"292_CR6","doi-asserted-by":"publisher","first-page":"380","DOI":"10.1016\/j.amjms.2016.01.011","volume":"351","author":"R Chen","year":"2016","unstructured":"Chen R, Ovbiagele B, Feng W. Diabetes and stroke: epidemiology, pathophysiology, pharmaceuticals and outcomes. Am J Med Sci. 2016;351:380\u20136.","journal-title":"Am J Med Sci"},{"key":"292_CR7","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1038\/nrneurol.2009.231","volume":"6","author":"ND Kruyt","year":"2010","unstructured":"Kruyt ND, Biessels GJ, Devries JH, Roos YB. Hyperglycemia in acute ischemic stroke: pathophysiology and clinical management. Nat Rev Neurol. 2010;6:145\u201355.","journal-title":"Nat Rev Neurol"},{"key":"292_CR8","doi-asserted-by":"publisher","DOI":"10.1177\/1756285617731686","volume":"11","author":"D Mi","year":"2018","unstructured":"Mi D, Wang P, Yang B, Pu Y, Yang Z, Liu L. Correlation of hyperglycemia with mortality after acute ischemic stroke. Ther Adv Neurol Disord. 2018;11:1756285617731686.","journal-title":"Ther Adv Neurol Disord"},{"key":"292_CR9","doi-asserted-by":"publisher","first-page":"1577","DOI":"10.1038\/jcbfm.2010.102","volume":"30","author":"ND Kruyt","year":"2010","unstructured":"Kruyt ND, Biessels GJ, DeVries JH, Luitse MJA, Vermeulen M, Rinkel GJE, et al. Hyperglycemia in aneurysmal subarachnoid hemorrhage: a potentially modifiable risk factor for poor outcome. J Cereb Blood Flow Metab J Int Soc Cereb Blood Flow Metab. 2010;30:1577\u201387.","journal-title":"J Cereb Blood Flow Metab J Int Soc Cereb Blood Flow Metab"},{"key":"292_CR10","doi-asserted-by":"publisher","first-page":"939735","DOI":"10.3389\/fneur.2022.939735","volume":"13","author":"VAL Huppertz","year":"2022","unstructured":"Huppertz VAL, Pilz W, Pilz Da Cunha G, de Groot LCPGM, van Helvoort A, Schols JMGA, et al. Malnutrition risk and oropharyngeal dysphagia in the chronic post-stroke phase. Front Neurol. 2022;13:939735.","journal-title":"Front Neurol"},{"key":"292_CR11","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1007\/s00455-012-9414-0","volume":"28","author":"MA Crary","year":"2013","unstructured":"Crary MA, Humphrey JL, Carnaby-Mann G, Sambandam R, Miller L, Silliman S. Dysphagia, nutrition, and hydration in ischemic stroke patients at admission and discharge from acute care. Dysphagia. 2013;28:69\u201376.","journal-title":"Dysphagia"},{"key":"292_CR12","doi-asserted-by":"publisher","first-page":"58","DOI":"10.1016\/j.nut.2017.02.014","volume":"41","author":"A Sanz-Paris","year":"2017","unstructured":"Sanz-Paris A, \u00c1lvarez Hern\u00e1ndez J, Ballesteros-Pomar MD, Botella-Romero F, Le\u00f3n-Sanz M, Mart\u00edn-Palmero \u00c1, et al. Evidence-based recommendations and expert consensus on enteral nutrition in the adult patient with diabetes mellitus or hyperglycemia. Nutr Burbank Los Angel Cty Calif. 2017;41:58\u201367.","journal-title":"Nutr Burbank Los Angel Cty Calif"},{"key":"292_CR13","doi-asserted-by":"publisher","first-page":"E996.","DOI":"10.3390\/nu11050996","volume":"11","author":"JJ L\u00f3pez-G\u00f3mez","year":"2019","unstructured":"L\u00f3pez-G\u00f3mez JJ, Delgado-Garc\u00eda E, Coto-Garc\u00eda C, Torres-Torres B, G\u00f3mez-Hoyos E, Serrano-Valles C, et al. nfluence of hyperglycemia associated with enteral nutrition on mortality in patients with stroke. Nutrients. 2019;11:E996.","journal-title":"Nutrients"},{"key":"292_CR14","doi-asserted-by":"publisher","first-page":"2386.","DOI":"10.3390\/nu14122386","volume":"14","author":"E Kokubo","year":"2022","unstructured":"Kokubo E, Morita S, Nagashima H, Oshio K, Iwamoto H, Miyaji K. Blood glucose response of a low- carbohydrate oral nutritional supplement with isomaltulose and soluble dietary fiber in individuals with prediabetes: a randomized, single-blind crossover trial. Nutrients. 2022;14:2386.","journal-title":"Nutrients"},{"key":"292_CR15","doi-asserted-by":"publisher","first-page":"3273","DOI":"10.1016\/j.clnu.2020.02.036","volume":"39","author":"A Sanz-Par\u00eds","year":"2020","unstructured":"Sanz-Par\u00eds A, Mat\u00eda-Mart\u00edn P, Mart\u00edn-Palmero \u00c1, G\u00f3mez-Candela C, Camprubi Robles M. Diabetes-specific formulas high in monounsaturated fatty acids and metabolic outcomes in patients with diabetes or hyperglycaemia. A systematic review and meta-analysis. Clin Nutr. 2020;39:3273\u201382.","journal-title":"Clin Nutr"},{"key":"292_CR16","doi-asserted-by":"publisher","first-page":"2267","DOI":"10.2337\/diacare.28.9.2267","volume":"28","author":"M Elia","year":"2005","unstructured":"Elia M, Ceriello A, Laube H, Sinclair AJ, Engfer M, Stratton RJ. Enteral nutritional support and use of diabetes-specific formulas for patients with diabetes: a systematic review and meta-analysis. Diabetes Care. 2005;28:2267\u201379.","journal-title":"Diabetes Care"},{"key":"292_CR17","doi-asserted-by":"publisher","first-page":"E1905.","DOI":"10.3390\/nu11081905","volume":"11","author":"O Ojo","year":"2019","unstructured":"Ojo O, Weldon SM, Thompson T, Crockett R, Wang X-H. The effect of diabetes-specific enteral nutrition formula on cardiometabolic parameters in patients with type 2 diabetes: a systematic review and meta-analysis of randomised controlled trials. Nutrients. 2019;11:E1905.","journal-title":"Nutrients"},{"key":"292_CR18","doi-asserted-by":"publisher","first-page":"926","DOI":"10.1002\/jpen.1035","volume":"42","author":"Y Shao","year":"2018","unstructured":"Shao Y, Heng W, Li S, Xu Y, Hu G. Tube feeding with a diabetes-specific enteral formula improves glycemic control in severe acute ischemic stroke patients. J Parenter Enter Nutr. 2018;42:926\u201332.","journal-title":"J Parenter Enter Nutr"},{"key":"292_CR19","doi-asserted-by":"publisher","first-page":"806","DOI":"10.1016\/j.clnu.2008.06.011","volume":"27","author":"P Clav\u00e9","year":"2008","unstructured":"Clav\u00e9 P, Arreola V, Romea M, Medina L, Palomera E, Serra-Prat M. Accuracy of the volume-viscosity swallow test for clinical screening of oropharyngeal dysphagia and aspiration. Clin Nutr Edinb Scotl. 2008;27:806\u201315.","journal-title":"Clin Nutr Edinb Scotl"},{"key":"292_CR20","volume":"2012","author":"Y Zhang","year":"2012","unstructured":"Zhang Y, Chapman A-M, Plested M, Jackson D, Purroy F. The incidence, prevalence, and mortality of stroke in France, Germany, Italy, Spain, the UK, and the US: a literature review. Stroke Res Treat. 2012;2012:436125.","journal-title":"Stroke Res Treat"},{"key":"292_CR21","doi-asserted-by":"publisher","DOI":"10.1016\/j.jstrokecerebrovasdis.2022.106354","volume":"31","author":"K Sato","year":"2022","unstructured":"Sato K, Inoue T, Maeda K, Shimizu A, Ueshima J, Ishida Y, et al. Undernutrition at admission suppresses post-stroke recovery of trunk function. J Stroke Cerebrovasc Dis J Natl Stroke Assoc. 2022;31:106354.","journal-title":"J Stroke Cerebrovasc Dis J Natl Stroke Assoc"},{"key":"292_CR22","doi-asserted-by":"publisher","first-page":"100","DOI":"10.5114\/aoms.2016.61009","volume":"13","author":"KK Snarska","year":"2017","unstructured":"Snarska KK, Bach\u00f3rzewska-Gajewska H, Kapica-Topczewska K, Drozdowski W, Chor\u0105\u017cy M, Ku\u0142akowska A, et al. Hyperglycemia and diabetes have different impacts on outcome of ischemic and hemorrhagic stroke. Arch Med Sci AMS. 2017;13:100\u20138.","journal-title":"Arch Med Sci AMS"},{"key":"292_CR23","doi-asserted-by":"publisher","first-page":"2139.","DOI":"10.3390\/ijerph18042139","volume":"18","author":"E S\u00e1nchez-S\u00e1nchez","year":"2021","unstructured":"S\u00e1nchez-S\u00e1nchez E, Avellaneda-L\u00f3pez Y, Garc\u00eda-Mar\u00edn E, Ram\u00edrez-Vargas G, D\u00edaz-Jimenez J, Ordonez FJ. Knowledge and practice of health professionals in the management of dysphagia. Int J Environ Res Public Health. 2021;18:2139.","journal-title":"Int J Environ Res Public Health"},{"key":"292_CR24","doi-asserted-by":"publisher","first-page":"355","DOI":"10.1016\/S1474-4422(09)70025-0","volume":"8","author":"VL Feigin","year":"2009","unstructured":"Feigin VL, Lawes CMM, Bennett DA, Barker-Collo SL, Parag V. Worldwide stroke incidence and early case fatality reported in 56 population-based studies: a systematic review. Lancet Neurol. 2009;8:355\u201369.","journal-title":"Lancet Neurol"},{"key":"292_CR25","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1097\/JNN.0000000000000372","volume":"50","author":"A Nascimento","year":"2018","unstructured":"Nascimento A, Carvalho M, Nogueira J, Abreu P, Nzwalo H. Complications associated with nasogastric tube placement in the acute phase of stroke: a systematic review. J Neurosci Nurs J Am Assoc Neurosci Nurses. 2018;50:193\u20138.","journal-title":"J Neurosci Nurs J Am Assoc Neurosci Nurses"},{"key":"292_CR26","doi-asserted-by":"publisher","first-page":"1008","DOI":"10.1002\/jpen.1674","volume":"43","author":"MR Pitta","year":"2019","unstructured":"Pitta MR, Campos FM, Monteiro AG, Cunha AGF, Porto JD, Gomes RR. Tutorial on diarrhea and enteral nutrition: a comprehensive step-by-step approach. JPEN. J Parenter Enter Nutr. 2019;43:1008\u201319.","journal-title":"J Parenter Enter Nutr"},{"key":"292_CR27","first-page":"21","volume":"29","author":"M Le\u00f3n-Sanz","year":"2005","unstructured":"Le\u00f3n-Sanz M, Garc\u00eda-Luna PP, Sanz-Par\u00eds A, G\u00f3mez-Candela C, Casimiro C, Chamorro J, et al. Glycemic and lipid control in hospitalized type 2 diabetic patients: evaluation of 2 enteral nutrition formulas (low carbohydrate-high monounsaturated fat vs high carbohydrate). JPEN J Parenter Enter Nutr. 2005;29:21\u20139.","journal-title":"JPEN J Parenter Enter Nutr"},{"key":"292_CR28","first-page":"1626","volume":"17","author":"DA de Luis","year":"2013","unstructured":"de Luis DA, Izaola O, de la Fuente B, Terroba MC, Cuellar L, Cabezas G. A randomized clinical trial with two doses of an enteral diabetes-specific suplements in elderly patients with diabetes mellitus type 2. Eur Rev Med Pharm Sci. 2013;17:1626\u201330.","journal-title":"Eur Rev Med Pharm Sci"}],"container-title":["Nutrition &amp; Diabetes"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41387-024-00292-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41387-024-00292-4","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41387-024-00292-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,30]],"date-time":"2024-05-30T10:37:06Z","timestamp":1717065426000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41387-024-00292-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,30]]},"references-count":28,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["292"],"URL":"https:\/\/doi.org\/10.1038\/s41387-024-00292-4","relation":{},"ISSN":["2044-4052"],"issn-type":[{"value":"2044-4052","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,30]]},"assertion":[{"value":"13 October 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 May 2024","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 May 2024","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 May 2024","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"All patients signed informed consent before recruitment and randomisation. The study was carried out in accordance with the Declaration of Helsinki and all procedures were approved by the Medical Research Ethics Committee (CEIm) of East Valladolid under code CASVE-NM-17-315. This clinical trial was registered in  with code NCT03422900.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}}],"article-number":"34"}}