Glycemic Management of Hospitalized Patients Receiving Nutrition Support

Preethi Polavarapu, Srujana Pachigolla, Andjela Drincic

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Enteral nutrition (EN) and parenteral nutrition (PN) increase the risk of hyperglycemia and adverse outcomes, including mor-tality, in patients with and without diabetes. A blood glucose target range of 140–180 mg/dL is recommended for hospitalized patients receiving artificial nutrition. Using a diabetes-specific EN formula, lowering the dextrose content, and using a hypocaloric PN formula have all been shown to prevent hyperglycemia and associated adverse outcomes. Insulin, given ei-ther subcutaneously or as a continuous infusion, is the mainstay of treatment for hyperglycemia. However, no subcutaneous insulin regimen has been shown to be superior to others. This review summarizes the evidence on and provides recommendations for the treatment of EN-and PN-associated hyperglycemia and offers strategies for hypoglycemia prevention. The au-thors also highlight their institution’s protocol for the safe use of insulin in the PN bag. Randomized controlled trials evaluating safety and efficacy of targeted insulin therapy synchronized with different types of EN or PN delivery are needed.

Original languageEnglish (US)
Pages (from-to)427-439
Number of pages13
JournalDiabetes Spectrum
Volume35
Issue number4
DOIs
StatePublished - Sep 1 2022

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism

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