None listed
Conditions
Brief summary
Anecdotally, survivors of critical illness reported reduced appetite that persists after discharge from ICU, however this has not been quantified, Given critical illness is associated with an increased prevalence of malnutrition, and functional deficits occur well after ICU discharge, factors that may influence recovery of nutritional status and hence function require exploration. This study is a sub-study to 'The significance of hyperglycaemia in survivors of critical illness and potential mechanisms underlying development of type 2 diabetes (ACTRN12614000449639) that will recruit ICU survivors and a healthy cohort.
Interventions
No intervention will be provided. This observational study will compare the below measures in survivors of critical illness three-months post-intensive care admission compared to a 'healthy' population.
1. Anthropometrics:
Height, weight, weight history and circumferences (hip, waist, neck)
2. 24-hour dietary recall:
A 24-hour dietary recall will be taken by a qualified Dietitian on the study day to assess intake in the preceding 24 hour period (prior to overnight fast) and entered into Foodw
No intervention will be provided. This observational study will compare the below measures in survivors of critical illness three-months post-intensive care admission compared to a 'healthy' population. 1. Anthropometrics: Height, weight, weight history and circumferences (hip, waist, neck) 2. 24-hour dietary recall: A 24-hour dietary recall will be taken by a qualified Dietitian on the study day to assess intake in the preceding 24 hour period (prior to overnight fast) and entered into Foodworks dietary analysis software as a measure reflective of current energy and protein intake. 3. Oral Glucose tolerance and isotope breath tests: All participants will have fasted overnight to allow for accurate oral glucose and gastric emptying results. Recurrent venous blood samples will be used for the analysis of insulin secretion. Breath samples will be used for the analysis of gastric emptying. For gastric emptying, a solution containing water (450ml), glucose (75g), and 13C-octanoic acid solution (100mg) will be used. The concentration of CO2 and the percentage of 13CO2 present will be measured with an isotope ratio mass spectromoter (Europa Scientific, ABCA model 20/20, Crewe UK). Blood for use in the Oral Glucose Tolerance test will be obtained through a cannula in the antecubital vein. The time at which the glucose solution is finished by the participant is designated as Time (T)=0 min. Breath samples will be taken at at baseline, every 5 minutes for the first hour and then every 15min for the remaining 2 hour study time frame. Following measurement of CO2 and 13CO2 in the breath samples, a curve is plotted in which the area under the curve being used to calculate the gastric emptying coefficient and half emptying time. Mathematical modeling will be used in order to analyse the insulin secreting capacity with the results from the oral glucose tolerance test. 4. Measurement of blood glucose and plasma GLP-1, GIP, glucagon, and serum insulin and C-peptide concentrations: Blood samples will be collected every 30 minutes for 3 hours through the antecubital vein cannula and analysed for blood glucose concentrations. The hormones (serum, insulin, c-peptide, and plasma glucagon, GIP & GLP-1) will also be measured at these time points. 5. Energy buffet: An energy buffet will be provided to each participant at the end of the glucose tolerance test. This energy buffet is a standard buffet that has been validated in the assessment of energy intake in appetite and gastric emptying studies. Energy and protein consumption will be assessed using Foodworks dietary analysis software. 6. Visual analogue scales: Visual analogue scales to assess factors that affect appetite and intake will be conducted at 3-month followup at study baseline (prior to oral glucose tolerance test in a fasted state), 15 minutes prior to the energy buffet, and at the end of the energy buffet.
Sponsors
ICU Research, Royal Adelaide Hospital
Eligibility
Sex/Gender
All
Age
30 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
Patients will be identified through screening of intensive care admissions at the Royal Adelaide Hospital and will include all patients aged 30 years or older that have been discharged and are 3-months post-ICU admission. Healthy volunteers aged >=30 years will be used as a comparator.
Exclusion criteria
1) Inability to give informed consent 2) Pregnant or breastfeeding 3) Previous gestational diabetes 4) Acute or chronic pancreatitis 5) Medications known to affect glucose metabolism (e.g. steroids) or gastrointestinal motility (e.g. prokinetics, antidepressants, sedatives, opiates, anti-convulsant agents) 6) Previous gastrointestinal surgery (apart from appendectomy) 7) Vegetarian/vegan 8) Current or previous gastrointestinal disease or major dysfunction 9) Regular consumption of >20g alcohol or >10 cigarettes per day
Outcome results
None listed