OBJECTIVETo investigate the effects of microbiological and immunological enteral nutrition using composition of probiotics, glutamine, fish oil, and peptisorb on patients with gastrointestinal cancer complicated with diabetes mellitus.

METHODSFrom January 2007 to October 2010, 67 patients with gastrointestinal cancer complicated with diabetes mellitus were admitted to the Liaocheng People's Hospital of Shandong Province and were randomized into the treatment group(n=33, enteral nutrition with probiotics, glutamine, and fish oil) and the routine group(n=34, regular enteral nutrition). Fasting blood glucose(FBG), insulin(FINS), number of lymphocytes(including CD3(+)T cell, CD4(+)T cell, CD8(+)T cell, CD4(+)/CD8(+)) and natural killer (NK) cells of the two groups were detected on the day before surgery and postoperative day 3 and 7. Insulin resistance index (InHOMA-IR) was calculated by using the homeostasis model assessment(HOMA). The incidence of nosocomial infections and intestinal function recovery time, and length of hospital stay were collected.

RESULTSOn postoperative day 7, FINS[(8.4±3.7) mU/L vs. (13.7±5.4) mU/L, P<0.05] and InHOMA-IR(1.11±0.23 vs. 1.68±0.39, P<0.05) were lower in the treatment group than that in the routine group. The number of CD4(+)[(45.2±5.4)% vs. (38.1±2.9)%, P<0.05], CD4/CD8 (2.05±0.27 vs. 1.58±0.16, P<0.05), and NK cells [(19.5±6.6)% vs. (15.4±5.6)%, P<0.05] were higher in the treatment group. There were no significant differences in nosocomial infection [6.1%(2/33) vs. 17.6%(6/34), P>0.05] and intestinal function recovery time[(69.3±9.5) h vs. (70.1±11.6) h, P>0.05] between the two groups. However, the length of hospital stay [(17±3.8) d vs. (21±4.2) d, P<0.05] was significantly shorter in the treatment group.

CONCLUSIONFor patients with gastrointestinal cancer complicated with diabetes mellitus, microbiota enteral nutrition can reduce insulin resistance, improve the immune status, and promote postoperative recovery.