THE MANAGEMENT OF HYPERGLYCEMIA IN NONCRITICALLY-ILL HOSPITALIZED PATIENTS TREATED WITH CONTINUOUS ENTERAL OR PARENTERAL NUTRITION.
Endocr Pract. 2018 Jul 23;:
Authors: Vennard KC, Selen DJ, Gilbert MP
Abstract
Hyperglycemia is a common problem in hospitalized patients receiving artificial nutrition, and this development of hyperglycemia during parenteral nutrition therapy (PNT) and enteral nutrition therapy (ENT) increases the risk of hospital-related complications and mortality. This review aims to discuss the pathogenesis of hyperglycemia from artificial nutrition in the hospital, summarize current evidence on the treatment of hyperglycemia with insulin in these patients, and review current guidelines. A systematic literature review using PubMed and the Medical Subject Headings (MeSH) terms "hyperglycemia," "enteral nutrition," and "parenteral nutrition" were used to evaluate the current evidence available for treating non-critically ill patients with hyperglycemia who were receiving artificial nutrition. The literature review showed that few randomized control trials exist regarding treatment of hyperglycemia in this cohort of patients, and the multiple retrospective evaluations that have addressed this topic provided varied results. In general, intravenous (IV) continuous insulin infusion offers the best glycemic control; however, this route of insulin administration is often burdensome for floor patients and their care teams. Administration of scheduled Subcutaneous (SQ) insulin in patients on ENT or PNT is a safe and effective way to manage hyperglycemia, however limited data exist on an appropriate insulin regimen. Further prospective, randomized control trials are necessary to determine the optimal treatment of hyperglycemia for patients receiving ENT or PNT.
PMID: 30035626 [PubMed - as supplied by publisher]