Effect of enteral nutrition formula containing slow-release starch on blood glucose variability and prognosis in patients with severe acute pancreatitis

Objective To explore the impact of enteral nutrition formula containing slow-release starch on blood glucose variability and prognosis in patients with severe acute pancreatitis (SAP).

Methods A total of 204 SAP patients were enrolled and randomly divided into control group and observation group using a random number table method, with 102 patients in each group. The control group received early enteral nutrition support with a standard enteral nutrition formula, while the observation group received early enteral nutrition support with an enteral nutrition formula containing slow-release starch. Blood glucose variability indicatorslargest amplitude of glycemic excursions (LAGE), standard deviation of blood glucose (SDBG), blood glucose coefficient of variation (BGCV), mean blood glucose (MBG), mean amplitude of glycemic excursions (MAGE), and time in range (TIR)were compared between the two groups after treatment, along with clinical indicators during hospitalization, inflammatory markersprocalcitonin, C-reactive protein, interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α), and nutritional indicators (albumin, prealbumin) levels. Kaplan-Meier analysis was conducted to assess the prognosis of the two groups, and multivariate Cox regression analysis was performed to identify factors influencing prognosis.

Results After treatment, the observation group exhibited lower levels of MBG, LAGE, SDBG, BGCV, MAGE, and a higher TIR compared with the control group (P < 0.05). During hospitalization, the observation group had a shorter duration of enteral nutritiontherapy, lower insulin usage, and lower incidence rates of multiple organ failure and infectious pancreatic necrosis compared with the control group (P < 0.05). After treatment, the observation group had lower levels of procalcitonin, C-reactive protein, IL-6, and TNF-α compared with the control group (P < 0.05); however, there were no statistically significant differences in albumin and prealbumin levels between the two groups (P>0.05). Kaplan-Meier analysis showed that the cumulative mortality rate in the observation group was 12.75%, which was lower than the 17.65% in the control group (Log-rank χ²=4.361, P=0.037). Multivariate Cox regression analysis revealed that TIR after treatment (HR=0.920; 95%CI, 0.869 to 0.974) was an independent protective factor for prognosis in SAPpatients (P < 0.05), while infectious pancreatic necrosis (HR=4.269; 95%CI, 1.922 to 9.482) was an independent risk factor for prognosis in SAP patients (P < 0.05).

Conclusion Enteral nutrition formula containing slow-release starch helps stabilize blood glucose variability, control inflammatory marker levels, improve nutritional status, and prognosis in SAP patients. Both TIR and infectious pancreatic necrosis are closely related to the prognosis of SAP patients.