ENTERAL NUTRITION

Diben DRINK
Diben DRINK

Compared to the standard sip feed, Average content per 100 ml:
Caloric value 630 kJ
Prescribing Information:
Food for special medical purposes:

supplemental nutrition with Diben DRINK

+
(= 150 kcal)
Nutritionally complete high energy (1.5 kcal/ml), high protein sip feed. High in
Fat 7.0 g
of which saturated fatty acids
of which medium chain fatty acids
1.7 g
1.2 g
monounsaturated fatty acids (MUFA), carbohydrate modified, with fibre. Free
from gluten. Clinically free from lactose and purine, low in cholesterol and significantly improves
sodium.
of which monounsaturated fatty acids 3.8 g
· POSTPRANDIAL GLYCAEMIC RESPONSE
+ of which polyunsaturated fatty acids 1.5 g Intended use:
Significantly improved glycaemic control of which EPA+DHAp 0.05 g For the dietary management of patients with or at risk of malnutrition in parti-
of which cholesterol
Carbohydrates
≤ 6 mg
13.1 g
cular with impaired glucose metabolism.
· LONGTERM GLYCAEMIC CONTROL
Dosage:
of which starch 5.3 g Dosage should be calculated by a dietician or clinician. For supplementary
of which sugars 2.5 g nutrition 2 – 3 bottles/day, for complete nutrition 5 bottles/day.
Significantly reduced postprandial hyperglycaemia of which fructose
of which lactose
1.9 g
≤ 0.5 g Important notes:
Fibre 2.0 g To be used under medical supervision only. For supplementary or complete nu-
Protein 7.5 g trition. Fluid supply should be monitored. If Diben DRINK is used as sole source

+
Bread unit 1.1 BU of nutrition it is recommended to monitor mineral status regularly. Supplemen-
tation in particular of magnesium may be needed. Not suitable for children < 3
Significantly improved longterm glycaemic control Carbohydrate units
Water
1.3 CU
79 ml years. Not for parenteral use.
Osmolarity 350 – 390* mosmol/l Antidiabetic therapies should be adjusted according to the results of regular
Osmolarity 440 – 490* mosmol/ blood glucose moni toring. It may be necessary to adapt already implemented

+
kg H2O medical therapy when the nutrition regimen is modified (e.g. daily dose, feeding

Is safe and well-tolerated

Minerals and trace elements
Sodium 65/70* mg
formula). In particular the transition from standard enteral formulas or from
high carbohydrate diabetic enteral formulas may need a dose reduction of in-
Results from controled
Potassium 130 mg sulin or oral antidiabetic drugs. randomized

© Fresenius Kabi Deutschland GmbH. Reproduction and distribution - only with prior written authorization
Chloride 55 mg
Handling and storage:
double-blind trial
+
Calcium 150 mg
Magnesium 15 mg Store at room temperature. Opened bottles may be stored in a refrigerator for
Better taste* increases compliance Phosphorus 95 mg up to 24 hours. Packed under special atmosphere. Shake well before enjoying.
Drink slowly!
Iron 2.0 mg
Zinc 1.5 mg Contraindications:
µg
resulting in a decreased risk for

R E S U LT S
Copper 300 Not suitable where enteral nutrition is not permitted, such as in acute gastro-
Manganese 0.4 mg intestinal bleeding, gut atonia, ileus and others. Not suitable for patients with
Iodide 30 µg severe form of malassimilation. Not suitable for patients with congenital inability

Glucose
diabetes-associated longterm complications Fluoride 0.2 mg to metabolise nutrients contained in Diben DRINK.
Chromium
Molybdenum
Selenium
10
15
10
µg
µg
µg
Patients
Vitamins
Vit. A 120 µg RE Ingredients:
ß-Carotene 300 µg
Vit. D 3 2.0 µg Water, milk protein, modified starch, maltodextrin, vegetable oils, fructose, me-
Vit. E 3.0 mg α-TE dium chain triglycerides (MCT), minerals, flavourings◆, fish oil, emulsifiers (soya
Vit. K 1 16.7 µg lecithin, E 471), choline hydrogen tartrate, vitamins, acidity regulatory
Vit. B 1
Vit. B2
Niacin
0.2
0.3
3.0
mg
mg
mg NE
(E 524), sweeteners (E 954, E 952), trace elements.
◆
amount/position depending on flavour
Double-blind trial
Vit. B6 0.3 mg
Vit. B12 0.6 µg
Pantothenic acid 1.2 mg
Biotin 7.5 µg References:
Folic acid 50 µg
Vit. C 15 mg 1. Mayr P: A low carbohydrate, high moniunsturated fatty acid oral nutritional

T IAL
Choline 26.7 mg supplement improves glycaemic control in type 2 diabetes. Poster ESPEN 2013
Caffeine ■ 0.5 mg 2. Mayr P: A diabetes-specific low carboyhdrate, high monounsaturated fatty
Caloric distribution (energy %): acid oranl nutritional supplement improves glycaemic control in type 2 diabetic
Protein 20 %, Fat 42 %, Carbohydrates 35 %, Fibre 3 % patients. Manuscript submitted for publication.

* Depending on flavour ■ Cappuccino p

Eicosapentaenoic acid + docosahexaenoic acid

Results from controlled

Fresenius Kabi Deutschland GmbH

7390321 (09/13 AC)

Else-Kröner-Straße 1
randomized double-blind trial
61352 Bad Homburg v.d.H., Germany
Phone: +49 (0) 61 72 686-0
enteral.nutrition@fresenius-kabi.com
www.fresenius-kabi.com
*superior taste of Diben DRINK versus competitor products was shown in an independent taste test, data is on file
 8

(mmmol/l)
Diben DRINK ( n = 20)

Clinical Study Baseline adjusted changes in blood glucose 0-240min

8
Control (n = 20) 800
Postprandial peak blood glucose

(mmmol/l)
Diben DRINK ( n = 20) 6

concentration
Control (n = 20) 800
6
4 iAUC0-240
600

concentration
8
Wilcoxon test Diben DRINK (n = 20) Control (n = 20)

(mmmol/l)
Glycaemic control and tolerance with Diben DRINK were investigated Diben DRINK ( n = 20)
600
16
Postprandial blood glucose was

mmol/l*min
4

blood glucose
Control (n = 20) 800
compared to a fibre containing standard sip feed. 2
6 400 14
n.s. * * significantly lower with Diben

concentration

mmol/l*min
inglucose
2 12
DRINK vs. the standard supplement
400
0
4
600
200
in weeks 6 and 12.

in blood
10

Changes

mmol/l
D AY 1
0

mmol/l*min
glucose
200
-2 8
} Significantly reduced post-

Changes
2 400
0
Study design: Dosage: 0 30 60 90 120 150 180 210 240 prandial hyperglycaemia

Changes in blood
p = 0.6247

n.s. = non-significant
6
-2
Controlled, prospective, randomised, 2 x 200 ml/day (600 kcal/day) 0
0
200 4
0 30 60 90 120 150 180 210 240 p = 0.6247
double-blind, mono-centre
Endpoints: 2
Patients: Postprandial blood glucose
-2
0
0
0 30 60 90 120 150 180 210 240 p = 0.6247 Day 1 Week 6 Week 12
Type II diabetics on oral diabetic
Postprandial peak blood glucose p = 0.0839 *p < 0.0001 *p < 0.0001
medication in need of nutritional Postprandial blood glucose response was comparable between
(iAUC 0-240 min)
support treatment groups at the first assessment.
Glycosylated haemoglobin (HbA1C) 8
Number of patients: HbA1c

(mmmol/l)
Diben DRINK (n = 20) *
Lipid parameters 8 Control (n = 20) 800
40 (20/20)

(mmmol/l)
6 Diben DRINK (n = 20) * Diben DRINK (n = 20)
Tolerability 0.5

concentration
Control (n = 20) 800 Diben DRINK (n Control
= 20) (n = (n
Control 20)
= 20) Diben improved longterm
Duration: Compliance & palatability 6
4
600
0.25
8
n.s.
glycaemic control:

concentration
8
n.s.
12 weeks Safety 0
HbA1c was significantly more

(mmmol/l)
Diben DRINK (n = 20) * 7
600 n.s.
Significantly
reduced from baseline to week 12

mmol/l*min
blood glucose
4 -0.25
Control (n = 20) 800
reduced
2
6 400 6
-0.5 in the Diben group compared to

WEEK 6

concentration

mmol/l*min
inglucose
2 5 the control group.

%(%)
400 -0.75
0 600
4 200

HbA1c
in blood
-1.0
4

Changes
} Significantly improved

n.s. = non-significant
0

mmol/l*min
glucose
200 -1.25
3

+
-2

Changes
2
Study formulas (per 600 kcal) The results show that Diben DRINK with *
400
0 -1.5 longterm glycaemic control
2

Changes in blood
0 30 60 90 120 150 180 210 240
-2 p < 0.0001
-1.75
0
0 1
200
Diben DRINK Control 0 30 60 90 120 150 180 210 240 *
p < 0.0001 -2.0

MUFA -2
In week 6 postprandial blood glucose levels were significantly
0
0
Day 1
Day 1 Week 6
Week 6
Week 12
Week 12
*p < 0.05

lower with Diben DRINK compared to the standard supplement *

0 30 60 90 120 150 180 210 240
p < 0.0001
between 30 and 180 minutes post ingestion.

Energy 600 kcal 600 kcal modified carbohydrates 8 *

Lipid metabolism (iAUC)
Protein 30 g (20 en%) 22,4 g (15 en%)

(mmmol/l)
+ Diben DRINK (n = 20) 14000
Fat 28 g (42 en%) 23,2 g (35 en%) Diben DRINK and the

+
8 * 800 Diben DRINK (n = 20) Control (n = 20)
Control (n = 20)

(mmmol/l)
MCT
13000
MUFA 15,2 g (23 en%) 15,2 g (23 en%) 6 Diben DRINK (n = 20) control group showed no

concentration
MCT 4,8 g (7en%) - Control (n = 20) 800 12000
adverse effects on serum
6
PUFA 6,0 g (9 en%) 6,4 g (9,8 en%) 600
triglycerides or other

concentration
4 * 11000
8

+
(mmmol/l)
Carbohydrate 52,4 g (35 en%) 71,2 g (47 en%) Diben DRINK (n = 20) 10000 lipid parameters.

WEEK 12
fish oil

mg/dl*min
600

blood glucose

mmol/l*min
Fibre 8,0 g (3 en%) 8,0 g (2,7 en%) 4 800
2
Control (n = 20) 9000
6 400

concentration
inglucose
} No adverse effects on

mmol/l*min
8000
2 400
is effective in improving glycaemic control 0
4
600
200
7000 lipid metabolism
in blood
Changes
6000
without adverse effects on lipid metabolism. glucose
0

mmol/l*min
Changes 200
-2
2 400 5000
0
Changes in blood

0 30 60 90 120 150 180 210 240 * 4000

-2 p < 0.0001
Day 1 Week 6 Week 12
0
0 In week
0
1230
postprandial
60
blood
90
glucose
120
levels150were significantly
180 210 240 * 200
p < 0.0001
lower with Diben DRINK compared to the standard supplement
-2 between 30 and 210 minutes after ingestion.
0

} 0Significantly
30 60 improved
90 glycaemic
120 150 control
180 210 240 *
p < 0.0001