Current opinion in clinical nutrition and metabolic care
-
Curr Opin Clin Nutr Metab Care · Jul 2008
ReviewTight glucose control in intensive care units: an update with an emphasis on nutritional issues.
Tight glucose control in ICU patients is now regarded as a goal of successful care. Some challenge this on the basis that it produces no benefit and may cause harm. We review the recent literature with an emphasis on nutritional aspects. ⋯ Without knowledge of nutrition provision in terms of carbohydrate, total energy intake and route of administration, some studies are difficult to interpret. It is currently difficult to recommend routine use of tight glucose control in the ICU. Many clinicians have adopted regimes to control glucose between 5.0-9.0 mmol/l.
-
Curr Opin Clin Nutr Metab Care · Jul 2008
ReviewGlucagon-like peptide receptor agonists and dipeptidyl peptidase-4 inhibitors in the treatment of diabetes: a review of clinical trials.
To discuss the virtues and shortcomings of the glucagon-like peptide-1 receptor agonists and the dipeptidyl peptidase-4 inhibitors in the treatment of type 2 diabetes. ⋯ The benefits and position of the glucagon-like peptide-1 analogues and the dipeptidyl peptidase-4 inhibitors in the diabetes treatment algorithm will be clarified when we have long-term trials with hard cardiovascular endpoints and data illustrating the effects on the progression of type 2 diabetes.
-
Curr Opin Clin Nutr Metab Care · May 2008
ReviewIssues related to gluten-free diet in coeliac disease.
In the last few years, knowledge about coeliac disease has significantly improved, resulting in a better understanding of disease pathogenesis, diagnosis and therapy. This review describes the latest progress in research concerning treatment with gluten-free diet in patients with coeliac disease. ⋯ Gluten-free diet remains the cornerstone of therapy of coeliac disease. More studies addressing the need of gluten-free diet for cases of 'potential' coeliac disease are necessary, as well as studies linking the best available analytical detection of gluten to the clinical threshold of tolerance.
-
Curr Opin Clin Nutr Metab Care · May 2008
ReviewEarly nutritional therapy: the role of enteral and parenteral routes.
Early nutrition is defined as the initiation of nutritional therapy within 48 h of either hospital admission or surgery. However, optimal timing for initiation of nutritional therapy through either enteral or parenteral routes remains poorly defined with the existing data. We reviewed the recent literature investigating the role of early enteral and parenteral nutrition in critical illness and perioperative care. ⋯ Early enteral nutrition remains the first option for the critically ill patient. However, there seems to be increased favor for combined enteral-parenteral therapy in cases of sustained hypocaloric enteral nutrition. The key issue is when the dual regimen should be initiated. Although more study is required to determine the optimal timing to initiate a combined enteral-parenteral approach, enteral nutrition should be initiated early and parenteral nutrition added if caloric-protein targets cannot be achieved after a few days.
-
Curr Opin Clin Nutr Metab Care · May 2008
ReviewDietary approaches to the prevention of food allergy.
The primary prevention of food allergy and atopy has become a public health priority in developed countries. Although some preventive dietary interventions have entered common practice, the level of evidence underpinning these strategies varies. ⋯ Although there is evidence for the primary dietary prevention of eczema and possible respiratory allergies, data on food allergy prevention have, so far, remained less convincing. Further prospective research is needed to clarify the effectiveness of dietary interventions in primary food allergy prevention.