Any medical personnel? My mother needs help!
 

I am hoping there is someone on this forum with medical background who might be able to help my mother. She is 71 years old and is in the later stages of Huntington's Disease.

She lost her ability to swallow about 18 months ago and is being fed through a G-Tube. She is fed 6 cans of Jevne per day through the tube. Yesterday she had a fever and the nurse took a urine and blood sample to the lab. She has a urinary tract infection that antibiotics should take care of. However, they are going to re-run the blood work on Friday because her blood sugar was elevated.

The Jevne is mostly glucose, so I'm sure she has probably developed Type 2 diabetes from all that sugar. I tried searching the web to find other liquid supplements for diabetics, but the only ones I could find are still 40% carbs (very high in fructose)! I can't begin to believe that something like that would help!

Does anyone know of a liquid nutritional supplement that can be fed through a G-Tube that would be appropriate for a diabetic? It should also be high calorie because HD patients need lots of calories and she is very thin.

I would really appreciate any help you can give us.

hi Peg,

I've redirected your post here to the Health forum :)

I know what you mean about most of the liquid formulas used for tube feeding. Yes, they're mostly high-fructose corn syrup, and soy- or cow milk casein protein. And the fat source is high polyunsaturate too, usually soybean oil. It used to amaze me that when patients' blood sugar would sky-rocket on these formulas, the response was merely to administer insulin, as if it was no big deal.

We used to use a formula called Compleat B, made from real food. I don't know if it's still produced or not, that was 9 yrs ago. I'll do a search, and see what I can find. :)

Doreen

Just another thought, while I'm searching ... infections themselves will cause elevated blood sugars, so it might be worth having blood sugar levels checked again after the UTI has been eradicated.

Doreen

Compleat enteral formulas are still available, made by Novartis. They're blenderized from real food .. meats, vegetables and fruits. I do recall that the formulas tend to be thick, and the tubes clogged frequently. However, that was in the Intensive Care setting, where enteral feeding tubes were temporary naso-duodenal tubes, and usually narrower than a gastrostomy tube. Plus, at the time we used a gravity-drip system, whereas pumps are used now to ensure consistent delivery.

The regular Compleat formula is 53% carbohydrate - including fiber from vegetables and fruits, and 31% fat. There is also a Diabetisource formula, for more glucose control. It's 36% carbohydrate, from maltodextrin, fructose, vegetables and fruits, and 44% fat. It's also a bit higher in protein than the regular Compleat formula, 20% as opposed to 16%.

You can read more about their various enteral feeding products at the Novartis website.

hth,

Doreen

Thanks so much for your help. Hopefully the high blood sugar is from the infection and not diabetes, but if it is diabetes at least I know where to look for alternatives. We do use a gavity feed system instead of a pump. This was recommended by her physician because of acid reflux (it is so severe she has needed transfusions because of bleeding caused by the reflux).

I have read that we could blenderize real food and feed it through the tube, but the article also stated that it caused frequent clogging of the tube. She has had so many problems with the tube (it's been replaced 5 times already), so I would hate to think of clogging it with food.

Thanks, again!

OK, promise not to laugh??? We used to use Diet Coke to unclog blocked feeding tubes (for adults only, of course). It had to be specifically Coke ... and I tell you, it worked! The phosphoric acid in it would eat through anything. Most of our clog problems were due to having to give medications through the tubes as well as the food ... and many meds come as whole tablets that were impossible to crush into small enough bits to pass through the openings at the end of the tube.

Doreen

doreen...

after reading some other uses for Diet Coke (including the one above), it's frightening to think I used to sometimes drink 2 liters of that stuff a day! Eeek! Maybe this is a bad idea, but is there some way to safely thin an especially thick enteral formula so that it isn't as likely to plug up the feeding tube? Just a thought...

Not really, unless a person stood there and manually kept shaking and mixing it up ... Even if diluted with water, the heavier formula particles would gradually separate out and sink to the bottom of the bag.

As well, formulas have a certain calorie content per can. The person is still going to require x calories a day .... diluting the formula will mean additional volume .. depending on how much extra water is added, it can lead to fluid overload :(

Doreen

Thanks for the tip about Diet Coke! My mother does get her meds through the feeding tube. The doctor tries to prescribe liquid meds much as possible, but some only are available in pill form. We use a mortar and pestel to crush them as fine as possible, then dissolve them in warm water. We flush the tube with water immediately afterward, and so far have not had much of a problem with clogging. If we do need to switch liquid nourishment, though, and the clogging becomes a problem we will know what to do!

Hi Pegm,
Just one more suggestion.
I'm also an ICU nurse and in that setting, for the last couple of years we routinely flush our feeding tubes every 4 hours with 20 mL of tap water. It definitely helps prevent clogging.
And the high blood sugars could well be just from the high sugar feeds. We find these days that almost all of our patients receiving enteral feeding also require insulin! These patients aren't diabetic and their blood sugars return to normal when the feeds are stopped. I wonder if the doctors will ever figure out a better regime of feeds!
Good luck Pegm.

:rose:Rosebud:rose: