Eating food is an important act of life, providing nutrition and pleasure. But not everyone can eat normally, and some may require nutrition support through a tube surgically placed into the stomach. One such tube is called the percutaneous endoscopic gastrostomy, or PEG, tube. If you are a diabetic with a PEG tube for nutrition, you may require a special diet to help meet your nutrient needs and control blood sugars.
PEG Tube
The PEG, also known as a feeding tube, is a surgically placed tube that is inserted into your stomach through a small opening in your skin. So part of the tube sits inside your stomach, while the rest is taped to the skin of your abdomen. You may need a PEG tube if you cannot eat at all, have difficulty chewing or swallowing or aspirate -- food goes into your lungs -- when you eat. The tube is then used as a way to feed nutritionally balanced liquid supplements, called tube feedings, directly into your stomach, bypassing your mouth and esophagus.
Diabetes and Diet
Diabetes is a chronic condition characterized by elevated blood sugars. Food, specifically carbohydrate-containing food, contributes to high blood sugars, which is why diet plays such an important role in the management of diabetes. For blood sugar control, the American Diabetes Association recommends you eat a consistent amount of carbohydrate at each meal. When receiving your nutrition through your PEG tube, all the carbohydrates come from your tube feeding formula. Your doctor and dietitian determine your specific diet needs, regarding both tube feeding formula choice and feeding schedule.
Diabetic Formulas
While it is generally accepted that the total carbohydrates are more of a concern than the type, you may have better blood sugar control using a diabetic specific tube feeding formula. In general, diabetic tube feeding formulas have less carbohydrate than standard formulas and more fiber. A 2005 review study published in "Diabetes Care" reviewed a total of 23 studies comparing the use of regular tube feeding formulas versus diabetic-specific tube feeding formulas on blood sugar control. The study found that individuals using the diabetic-specific tube feeding formulas had better blood sugar control, a reduced need for insulin and fewer complications.
Feeding Schedule
Your feeding schedule will be determined by your doctor or dietitian, and depends on your tolerance. If your stomach is functioning normally and you can tolerate large amounts of formula at a time, you will be prescribed bolus feeds. Bolus feeds are given several times a day, to mimic meal times, either pushed with a syringe or dripped in by gravity. If you are having difficulty tolerating your formula, such as nausea or vomiting, or cannot handle large amounts of formula at one time, your doctor may recommend you receive continuous tube feeds. On a continuous tube feeding schedule your tube feedings are given by a feeding pump machine at a slow rate over several hours a day. For diabetes, neither one is preferred over the other, although bolus feeds are more common through a PEG tube than continuous feeds.
References
- Langone Medical Center; PEG (Percutaneous Endoscopic Gastrostomy) Tube; May 2009
- Nutrition Care: What is Enteral Nutrition
- "Diabetes Care"; Enteral Nutritional Support and Use of Diabetes-Specific Formulas for Patients With Diabetes; Marinos Elia, et al.; September 2005
- American Diabetes Association: Carbohydrate Counting
- Abbott Nutrition: Diabetes: Glucerna
- Nestle Nutrition: Nutren Diabetes
