Glucose intolerance and diabetes mellitus in ulcerative colitis: Pathogenetic and therapeutic implications

Diabetes mellitus is one of the most frequent co-morbidities of ulcerative colitis patients.The epidemiological association of these diseases suggested a genetic sharing and has challenged gene identification.Diabetes co-morbidity in ulcerative colitis has also relevant clinical and therapeutic implications,with potential clinical impact on the follow up and outcome of patients.These diseases share specific complications,such as neuropathy,hepatic steatosis,osteoporosis and venous thrombosis.It is still unknown whether the coexistence of these diseases may increase their occurrence.Diabetes and hyperglycaemia represent relevant risk factors for postoperative complications and pouch failure in ulcerative colitis.Medical treatment of ulcerative colitis in patients with diabetes mellitus may be particularly challenging.Corticosteroids are the treatment of choice of active ulcerative colitis.Their use may be associated with the onset of glucose intolerance and diabetes,with difficult control of glucose levels andwith complications in diabetic patients.Epidemiologic and genetic evidences about diabetes co-morbidity in ulcerative colitis patients and shared complications and treatment of patients with these diseases have been discussed in the present review.

Women with overweight, mixed hyperlipidemia, intolerance to glucose and diastolic hypertension

Primarily healthy women who attended a practice of General Medicine were examined and coded data were evaluated using two statistical methods (n = 248, aged 36 ± 14 years). It was found that participants with LDL-related (mixed) hyperlipidemia showed higher blood pressure, a higher proportion of alcohol problems and/or smoking compared to normolipidemic women (p ≤ 0.05). These hyperlipidemic women who reported alcohol problems and/or smoking more often showed proteinuria and/or hematuria, rise of LDL/HDL, critical fasting blood glucose and lower HDL-cholesterol compared to hyperlipidemic women reporting healthy lifestyle (p ≤ 0.05). Likewise, high triglycerides were associated with rise of blood pressure and intolerance to glucose (p ≤ 0.05) and also with elevated total cholesterol. Alcohol-related hypertriglyceridemia overlapped with diastolic hypertension, rise of body weight and urine pathology, lowering of HDL-cholesterol and critical fasting blood glucose. The motivating message was that women with mixed hyperlipidemia and healthy lifestyle had functionally renal endothelium and healthy HDL-related baseline measures. Altogether, LDL-related hyperlipidemia and/or high triglycerides were correlated with diastolic hypertension whereby critical alcohol consumption declined renal endothelium and lowered HDL-cholesterol implicating baseline strategies to neutralize early risk factors.

One-time injection of calcitonin induces glucose intolerance in children with the first degree obesity

The effect of calcitonin on the blood glucose level in glucose-tolerance test of children with the first degree obesity was studied. Initial blood glucose level was normal and glucose-tolerance test per os didn’t expose glucose tolerance impairment in children under control. Calcitonin didn’t change initial glucose concentration but evoked impairment of glucose tolerance. The girls with the first degree obesity were more sensitive to hyperglycemic effect of calcitonin than the boys. Sex specificities must be taken into consideration in calcitonin treatment. Besides one ought mean that the increasing secretion of calcitonin occurs in stress-reactions. In these conditions endogenous calcitonin can make the same effect on the regulation of carbohydrate metabolism as exogenous injections of hormone.

LDL-Related Intolerance to Glucose, Diastolic Hypertension and Additive Effects of Smoking Were Found with Three Female Study Groups

Initial prodiabetic risk profiles were invented here with three female study groups consisting of primarily healthy women (A1: 1990-1999, n = 160;A2: 2009, n = 88;A: n = 248, 36 ± 14 years;B: 2014: n = 65, aged 37± 11 years). Significantly higher blood pressure was found comparing intolerance versus tolerance to glucose (p p p = 0.02), of fasting blood glucose (p = 0.07) and of urine pathology (p = 0.07). High LDL-C of women who reported smoking at baseline was correlated with diastolic hypertension whereby alcohol problems overlapped (p = 0.036, A). Unhealthy combinations were found consisting of LDL-related intolerance to glucose, LDL-related smoking, of alcohol-related hypertriglyceridemia or of combined drinking and smoking testing urine pathology over the course of time. Obese women were at direct risk for hypertension in the presence of high LDL-C and submaximal ratio of serum albumin to triglycerides (Alb/Trig). Obese women reacted highly sensitive to critical alcohol consumption showing then macroalbuminuria. Current participants who disowned daily alcohol consumption showed healthy morning urines and normal fasting blood glucose. Mild decrease of HDL-C was observed during heavy smoking of relatively young women who had normal biomarkers. Women with intolerance to glucose were at direct risk for hypertension whereby high LDL-C and/or smoking triggered prodiabetic risk profiles. Obese women had elevated LDL-C during hypertension and reacted highly sensitive to alcohol-related proteinuria and/or hematuria.

Brain-derived neurotrophic factor inhibits glucose intolerance after cerebral ischemia

Brain-derived neurotrophic factor is associated with the insulin signaling pathway and glucose me- tabolism. We hypothesized that expression of brain-derived neurotrophic factor and its receptor may be involved in glucose intolerance following ischemic stress. To verify this hypothesis, this study aimed to observe the changes in brain-derived neurotrophic factor and tyrosine kinase B receptor expression in glucose metabolism-associated regions following cerebral ischemic stress in mice. At day 1 after middle cerebral artery occlusion, the expression levels of brain-derived neurotrophic factor were significantly decreased in the ischemic cortex, hypothalamus, liver, skeletal muscle, and pancreas. The expression levels of tyrosine kinase B receptor were decreased in the hypothalamus and liver, and increased in the skeletal muscle and pancreas, but remained unchanged in the cortex Intrahypothalamic administration of brain-derived neurotrophic factor （40 ng） suppressed the de- crease in insulin receptor and tyrosine-phosphorylated insulin receptor expression in the liver and skeletal muscle, and inhibited the overexpression of gluconeogenesis-associated phosphoenolpy- ruvate carboxykinase and glucose-6-phosphatase in the liver of cerebral ischemic mice. However, serum insulin levels remained unchanged. Our experimental findings indicate that brain-derived neurotrophic factor can promote glucose metabolism, reduce gluconeogenesis, and decrease blood glucose levels after cerebral ischemic stress. The low expression of brain-derived neurotrophic factor following cerebral ischemia may be involved in the development of glucose intolerance.

Nutrition interventions and clinical outcomes of pregnant women with gestational diabetes mellitus: More than meets the eye

In the retrospective study by Luo et al regarding clinical outcomes in gestational diabetes mellitus(GDM),the results are statistically significant in favour of the benefits of individualized nutrition interventions enumerated therein.The study has provided important evidence to improve maternal and child health in the Asian population.The methods,however,appear to have considerable limi-tations,wherein the time point of diagnosis of GDM,severity of GDM,selection bias,compliance to therapy,important maternal covariates,observable microvascular abnormalities and the confounding effect of added insulin have not been considered.We have provided suggestions to improve the external validity of the study,including the use of Equator Network reporting guidelines and inclusion of overweight and obese patients in future studies.

Bidirectional link between periodontitis and systemic inflammation in diabetic retinopathy

Periodontitis is independently associated with numerous lifestyle diseases.Diabetic patients have approximately threefold increased odds of periodontitis,which in turn increases the risk of systemic inflammation.The study by Thazhe Poyil et al is an effort to establish the inflammatory link between diabetic retinopathy(DR)and periodontitis based on the periodontal inflamed surface area in diabetic patients with and without DR.To further advance the study,we suggest refining the eligibility criteria to explicitly state the clinical correlates of periodontitis and DR,larger sample size and improved sampling methodology,matching of baseline characteristics of the two groups,as well as improved statistical approach and interpretation of the study findings.Measurement of hemoglobin A1c(HbA1c)in studies comparing type 2 diabetes mellitus patients with DR of matched severity with and without periodontitis could provide a clearer picture of whether HbA1c level is indeed influenced by periodontitis.

Chiglitazar and Thiazolidinedione in patients with type 2 diabetes:Which is better?

This published Meta-Analysis by Lin et al is an indirect comparison between two drugs Chiglitazar and Thiazolidinedione which are commonly used for glycemic control in type-Ⅱ diabetes mellitus.In terms of safety and efficacy,this Meta-Analysis is inconclusive.

Spouses of patients with diabetes mellitus type 2 at increased risk of high blood glucose levels

Introduction: Diabetes mellitus type 2 is a growing threat in developing countries already burdened with high levels of infectious disease. Screening the general population has debatable advantages. This study aims to determine whether spouses of patients with diabetes mellitus have higher random blood glucose (RBG) levels as well as the benefit of RBG testing as a targetted screening tool. Methodology: The survey employed a cross-sectional comparative study of spouses’ of diabetics and non-diabetics attending the general out-patient department of the LagosStateUniversityTeaching Hospital (LASUTH), Ikeja. A modified WHO STEPS Surveillance Instrument and a one-touch Glucometer were used to collect data. Blood pressures and BMI were measured and correlated to blood glucose levels. Results: Prevalence of high RBG was found to be 7% among spouses of diabetics and 3.3% among spouses of non-diabetic patients. Mean RBG was 5.57 mmol/L and 7.7 mmol/L within the age group 40 - 49 years and 50 - 59 years respectively among spouses of diabetic patients compared to 5.4 mmol/L and 5.5 mmol/L within the same age group among the spouses non-diabetics. Spouses of patients with diabetes mellitus had higher systolic and diastolic blood pressures and BMI compared to spouses of non-diabetics. Conclusion: Being male, married to a diabetic patient, lower educational levels and higher body mass index are significantly associated with higher random blood glucose in the spouses of diabetic patients. Random blood glucose measurements are an effective screening tool and spouses of diabetic patients can benefit from targeted screening in controlled clinical settings.

SH2B1 regulation of energy balance, body weight, and glucose metabolism

The Src homology 2B(SH2B)family members(SH2B1,SH2B2 and SH2B3)are adaptor signaling proteins containing characteristic SH2 and PH domains.SH2B1(also called SH2-B and PSM)and SH2B2(also called APS)are able to form homo-or hetero-dimers via their N-terminal dimerization domains.Their C-terminal SH2 domains bind to tyrosyl phosphorylated proteins,including Janus kinase 2(JAK2),TrkA,insulin receptors,insulin-like growth factor-1 receptors,insulin receptor substrate-1(IRS1),and IRS2.SH2B1 enhances leptin signaling by both stimulating JAK2 activity and assembling a JAK2/IRS1/2 signaling complex.SH2B1 promotes insulin signaling by both enhancing insulin receptor catalytic activity and protecting against dephosphorylation of IRS proteins.Accordingly,genetic deletion of SH2B1 results in severe leptin resistance,insulin resistance,hyperphagia,obesity,and type 2 diabetes in mice.Neuronspecific overexpression of SH2B1βtransgenes protects against diet-induced obesity and insulin resistance.SH2B1 in pancreaticβcells promotesβcell expansion and insulin secretion to counteract insulin resistance in obesity.Moreover,numerous SH2B1 mutations are genetically linked to leptin resistance,insulin resistance,obesity,and type 2 diabetes in humans.Unlike SH2B1,SH2B2 and SH2B3 are not required for the maintenance of normal energy and glucose homeostasis.The metabolic function of the SH2B family is conserved from insects to humans.

Effect of Carbohydrate Intolerance and Gestational Diabetes on Obstetric and Perinatal Outcomes

Objectives: To compare the frequency of obstetric and perinatal complications among patients with carbohydrate intolerance (CHI) and gestational diabetes (GD). Materials and Methods: In a prospective study at the Civil Hospital of Culiacán, we studied 182 pregnant patients between 16 and 30 weeks of gestation (WG) who received a glucose tolerance test following the oral administration of 100 g of glucose. The patients were classified as normal (n = 53), CHI (n = 61) and GD (n = 68) between January 15 to November 30, 2012. The analyzed variables included the frequency of polyhydramnios, preeclampsia-eclampsia, obstetric hemorrhage, fetal macrosomia, and admission to a neonatal intensive care unit (NICU). Results: No significant differences were found between women with CHI and women with GD with respect to obstetric hemorrhage (P = 0.774), preeclampsia-eclampsia (P = 0.590), and macrosomia (P = 0.119). However, polyhydramnios was more frequent in CHI group (OR = 3) compared to GD, whereas admission to the NICU was lower in the CHI group compared to GD group (OR = 0.38). Conclusion: Preeclampsia-eclampsia, obstetric hemorrhage, and macrosomia were similar among patients with CHI and GD. In contrast, polyhydramnios was more frequent in patients with CHI compared to patients with GD, but admission to the NICU was more frequent in patients with GD.

Agenesis of the dorsal pancreas

During the last 100 years in medical literature,there are only 54 reports,including the report of Pasaoglu et al(World J Gastroenterol 2008;14:2915-2916),with clinical descriptions of agenesis of the dorsal pancreas in humans.Agenesis of the dorsal pancreas,a rare congenital pancreatic malformation,is associated with some other medical conditions such as hyperglycemia,abdominal pain,pancreatitis and a few other diseases.In approximately 50% of reported patients with this congenital malformation,hyperglycemia was demonstrated.Evaluation of hyperglycemia and diabetes mellitus in all patients with agenesis of the dorsal pancreas including description of fasting blood glucose,oral glucose tolerance test,glycated hemoglobin and medical treatment would be a future goal.Since autosomal dominant transmission has been suggested in single families,more family studies including imaging technologies with demonstration of the pancreatic duct system are needed for evaluation of this disease.With this letter to the editor,we aim to increase available information for the better understanding of this rare disease.

Clinical significance of glycated hemoglobin in the acute phase of ST elevation myocardial infarction

In population-based studies,including diabetic and nondiabetic cohorts,glycated hemoglobin A1c(HbA1c) has been reported as an independent predictor of allcause and cardiovascular disease mortality.Data on the prognostic role of HbA1c in patients with acute myocardial infarction(MI) are not univocal since they stem from studies which mainly differ in patients' selection criteria,therapy(thrombolysis vs mechanical revascularization) and number consistency.The present review is focused on available evidence on the prognostic significance of HbA1c measured in the acute phase in patients with ST-elevation myocardial infarction(STEMI) submitted to primary percutaneous coronary intervention(PCI).We furthermore highlighted the role of HbA1c as a screening tool for glucose intolerance in patients with STEMI.According to available evidence,in contemporary cohorts of STEMI patients submitted to mechanical revascularization,HbA1c does not seem to be associated with short and long term mortality rates.However,HbA1c may represent a screening tool for glucose intolerance from the early phase on in STEMI patients.On a pragmatic ground,an HbA1c testhas several advantages over fasting plasma glucose or an oral glucose tolerance test in an acute setting.The test can be performed in the non-fasting state and reflects average glucose concentration over the preceding 2-3 mo.We therefore proposed an algorithm based on pragmatic grounds which could be applied in STEMI patients without known diabetes in order to detect glucose intolerance abnormalities from the early phase.The main advantage of this algorithm is that it may help in tailoring the follow-up program,by helping in identifying patients at risk for the development of glucose intolerance after MI.Further validation of this algorithm in prospective studies may be required in the contemporary STEMI population to resolve some of these uncertainties around HbA1c screening cutoff points.

Human pluripotent stem cells:Towards therapeutic development for the treatment of lifestyle diseases

There are two types of human pluripotent stem cells: Embryonic stem cells(ESCs) and induced pluripotent stem cells(iPSCs),both of which launched themselves on clinical trials after having taken measures to overcome problems: Blocking rejections by immunosuppressants regarding ESCs and minimizing the risk of tumorigenicity by depleting exogenous gene components regarding iP SCs.It is generally assumed that clinical applications of human pluripotent stem cells should be limited to those cases where there are no alternative measures for treatments because of the risk in transplanting those cells to living bodies.Regarding lifestyle diseases,we have already several therapeutic options,and thus,development of human pluripotent stem cell-based therapeutics tends to be avoided.Nevertheless,human pluripotent stem cells can contribute to the development of new therapeutics in this field.As we will show,there is a case where only a short-term presence of human pluripotent stem-derived cells can exert long-term therapeutic effects even after they are rejected.In those cases,immunologically rejections of ESC-or allogenic iP SC-derived cells may produce beneficial outcomes by nullifying the risk of tumorigenesis without deterioration of therapeutic effects.Another utility of human pluripotent stem cells is the provision of an innovative tool for drug discovery that are otherwise unavailable.For example,clinical specimens of human classical brown adipocytes(BAs),which has been attracting a great deal of attention as a new target of drug discovery for the treatment of metabolic disorders,are unobtainable from living individuals due to scarcity,fragility and ethical problems.However,BA can easily be produced from human pluripotent stem cells.In this review,we will contemplate potential contribution of human pluripotent stem cells to therapeutic development for lifestyle diseases.

妊娠初期Th细胞因子与妊娠期糖尿病发生的相关性及对产后糖代谢异常的预测效能研究

目的分析妊娠初期辅助型T细胞(Th细胞)因子与妊娠期糖尿病发生的相关性及对产后糖代谢异常的预测效能。方法选取2019年1月至2021年1月在浙江省诸暨市妇幼保健院建档行规律产检、分娩的238例孕妇作为研究对象。在妊娠初期检测血清Th1细胞因子及Th2细胞因子,根据妊娠24~28周行75g葡萄糖耐量试验(OGTT)结果分为妊娠期糖尿病组(n=42)和对照组(n=196),比较两组妊娠初期Th细胞因子水平及其比值,通过受试者工作特征(ROC)曲线下面积(AUC)评价妊娠初期Th细胞因子对产后糖代谢异常的预测效能。结果妊娠期糖尿病组妊娠初期血清肿瘤坏死因子-α(TNF-α)水平高于对照组,白介素-10(IL-10)水平低于对照组,TNF-α/IL-4、IL-2/IL-10、γ-IFN/IL-10、TNF-α/IL-10均大于对照组,差异具有统计学意义(P<0.05);妊娠期糖尿病组妊娠24~28周胰岛素抵抗指数(HOMA-IR)、胰岛β细胞功能指数(HOMA-β)水平均高于对照组,差异具有统计学意义(P<0.05);经多因素Logistic回归分析,TNF-α、IL-10和TNF-α/IL-10均是妊娠期糖尿病发生的独立预测因素(P<0.05);经Pearson相关性分析,妊娠期糖尿病患者妊娠初期TNF-α/IL-10与妊娠24~28周HOMA-IR、HOMA-β均呈正相关(P<0.05);经ROC曲线分析,妊娠初期TNF-α/IL-10预测妊娠期糖尿病患者产后糖代谢异常的AUC为0.912。结论妊娠初期TNF-α/IL-10增大与妊娠期糖尿病发生的关系密切,对产后糖代谢异常具有较好的预测效能,可能成为早期筛查妊娠期糖尿病的重要指标。

Diabetes and hyperlipidemia: A direct quantitative analysis<br>—A direct analysis of the effects of insulin resistance on lipid levels in relation to atherosclerotic coronary artery disease

Introduction: Diabetes and hyperlipidemia are two major factors involved in cardiovascular disease. The medical treatment and reduction of the effects of these conditions are key modalities in the prevention of heart disease. The term diabetic dyslipidemia supports the hypothesis that insulin resistance is a potential cause of dyslipidemia. This research study is one of the few that attempts to quantify a direct relationship between insulin resistant states and dyslipidemias. Methods: Data was collected by a retrospective chart review of patients diagnosed with either glucose intolerance or diabetes and hyperlipidemia. Lipid levels and either glucose, in the glucose intolerant patients, or hemoglobin A1c values, in the diabetic patients, were recorded. The data used in our study compared changes over a 6 month period in either glucose or hemoglobin A1c with changes in total cholesterol, LDL, HDL, and triglycerides during that same time period. Results: A positive relationship was seen with both change over time in glucose and hemoglobin A1c levels with that of all components of the lipid panel. The strongest relationship was seen with comparisons involving triglycerides. Discussion: Our results show that there is a statistically significant relationship between patients with either glucose intolerance or diabetes and the different components of a lipid panel. Our research helps to reinforce the necessity to be vigilant in the treatment of both diabetes and hyperli-pidemia in regard to the prevention of heart disease. It is also one of the few studies that provides statistical evidence to such relationships.

Methyl Donors Supplementation Attenuates the Adverse Effects of Maternal High Fructose Diet of Offspring Emotional and Cognitive Behaviors

Free Fatty acid is an end-product of hepatic metabolism of fructose. Most of past studies have demonstrated significant relationship between gestational high fat diet and metabolic and physiology outcomes in offspring. However, there is a scarce of data extended to the effects of high fructose diet-fed dams on juveniles’ progeny. Therefore, the present experiment was designed to examine the later effects of maternal high fructose diet intake during pregnancy and lactation on juvenile offspring rats emotional behaviors and memory abilities. We tested whether methyl donors supplemented to that high fructose diet could reverse the adverse effects. We found at two months of age, anxiety-like behavior and depression-like behavior were elevated in off springs of mother fed to high fructose diet and a sex difference effect with males were more affected than females. In addition, behavioral outcomes indicated that the high fructose diet also impaired spatial working and recognition memories in the Y-maze and object recognition test respectively. Blood glucose intolerance increased significantly in juvenile males rats of dams fed with high fructose diet when compared to females. However, a supplementation of the maternal diet with methyl donors attenuated all these changes. Our study suggested a controlled fructose diet supplemented to methyl donors during critical period of brain developing (in utero and pre-weaning stage), otherwise that could induced irreversible detrimental effects on offspring behavior and cognitive health.

益生菌辅助应用对妊娠期糖尿病患者血糖控制和Th细胞因子的影响

目的探讨益生菌辅助应用对妊娠期糖尿病(GDM)患者血糖控制和Th细胞因子的影响。方法选取2021年4月—2022年4月温州医科大学附属第二医院收治的80例GDM患者,按照随机数字表法分为对照组(40例,常规治疗)和观察组(40例,益生菌联合常规治疗)。对比两组患者治疗效果,血糖、血脂控制情况,Th细胞因子水平,母婴结局。结果观察组总有效率为97.50%,高于对照组的85.00%(χ^(2)=3.914,P<0.05)。治疗后,观察组患者空腹血糖(FBG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)及稳态模型胰岛素抵抗指数(HOMA-IR)均低于对照组[观察组:(5.28±0.57)mmol/L、(6.49±0.71)mmol/L、(6.30±0.69)%、(17.26±1.96)mU/L、(4.05±0.54);对照组:(5.76±0.62)mmol/L、(7.29±0.83)mmol/L、(6.98±0.74)%、(18.98±2.22)mU/L、(4.86±0.56)],胰岛β细胞分泌指数(HOMA-β)高于对照组[观察组:(193.93±20.69);对照组:(167.96±17.74)],差异均有统计学意义(均P<0.05)。治疗后,观察组患者总胆固醇(TC)、三酰甘油(TG)及低密度脂蛋白(LDL)均低于对照组,高密度脂蛋白(HDL)均高于对照组(均P<0.05)。治疗后,观察组患者白细胞介素-2(IL-2)、干扰素-γ(IFN-γ)及肿瘤坏死因子-α(TNF-α)均低于对照组,白细胞介素-4(IL-4)、白细胞介素-10(IL-10)均高于对照组(均P<0.05)。观察组孕妇早产、剖宫产、羊水过多、产后感染、妊娠期高血压疾病、产后出血、低体质量儿、巨大儿、高胆红素血症及新生儿低血糖发生率均低于对照组(均P<0.05)。结论益生菌辅助治疗GDM患者可取得较好效果,可较好地控制血糖、血脂水平,改善Th细胞因子水平,改善母婴结局。

Comparison of sequential feeding and continuous feeding on the blood glucose of critically ill patients:a non-inferiority randomized controlled trial

Background:Glucose control is an important aspect in managing critically ill patients.The goal of this study was to compare the effects of sequential feeding(SF)and continuous feeding(CF)on the blood glucose of critically ill patients.Methods:A non-inferiority randomized controlled trial was adopted in this study.A total of 62 patients who were fed enteral nutritional suspension through gastric tubes were enrolled.After achieving 80%of the nutrition target calories(25 kcal·kg^(-1)·day^(-1))through CF,the patients were then randomly assigned into SF and CF groups.In the SF group,the feeding/fasting time was reasonably determined according to the circadian rhythm of the human body as laid out in traditional Chinese medicine theory.The total daily dosage of the enteral nutritional suspension was equally distributed among three time periods of 7 to 9 o’clock,11 to 13 o’clock,and 17 to 19 o’clock.The enteral nutritional suspension in each time period was pumped at a uniform rate within 2 h by an enteral feeding pump.In the CF group,patients received CF at a constant velocity by an enteral feeding pump throughout the study.Blood glucose values at five points(6:00/11:00/15:00/21:00/1:00)were monitored and recorded for seven consecutive days after randomization.Enteral feeding intolerance was also recorded.Non-inferiority testing was adopted in this study,the chi-square test or Fisher test was used for qualitative data,and the Mann-Whitney U test was used for quantitative data to determine differences between groups.In particular,a repeated measure one-way analysis of variance was used to identify whether changes in glucose value variables across the time points were different between the two groups.Results:There were no significant demographic or physiological differences between the SF and CF groups(P>0.050).The average glucose level in SF was not higher than that in CF(8.8[7.3–10.3]vs.10.7[9.1–12.1]mmol/L,Z=-2.079,P for non-inferiority=0.019).Hyperglycemia incidence of each patient was more common in the CF group than that in the SF group(38.4[19.1–63.7]%vs.11.8[3.0–36.7]%,Z=-2.213,P=0.027).Hypoglycemia was not found in either group.Moreover,there was no significant difference during the 7 days in the incidence of feeding intolerance(P>0.050).Conclusions:In this non-inferiority study,the average blood glucose in SF was not inferior to that in CF.The feeding intolerance in SF was similar to that in CF.SF may be as safe as CF for critically ill patients.