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Blood Glucose Control in Enteral Nutrition: Strategy for the Treatment of Hyperglycemia in Patients Receiving Enteral Nutrition

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Diet and Nutrition in Critical Care

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Abstract

Enteral nutrition is the main way to administer artificial nutrition to patients. It should be preferred to parenteral nutrition in all subjects whose gastroenteric tract is both anatomically and functionally undamaged. Enteral nutrition administration to diabetic patients, mainly those hospitalized in intensive care unit, is sometimes problematic because of the difficulties in managing glycemic control, due to the presence of insulin resistance which is always associated with acute illnesses. Several diabetes-specific enteral formulas are available in order to improve glycemic control. However, they do not receive unanimous approval from scientific societies committed to artificial nutrition. To date no specific guidelines exist for the insulinization of diabetic patients receiving enteral nutrition. This chapter supplies readers with recommendations concerning different insulinization strategies in diabetic patients as regards both the enteral nutrition induction and the subsequent enteral nutrition maintenance.

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Abbreviations

ALI:

Acute lung injury

ARDS:

Acute respiratory distress syndrome

ASPEN:

American Society for Parenteral and Enteral Nutrition

BUN:

Blood urea nitrogen

BW:

Body weight

DM:

Diabetes mellitus

EN:

Enteral nutrition

ESPEN:

European Society for Parenteral and Enteral Nutrition

ICU:

Intensive care unit

MCT:

Medium-chain triglycerides

PN:

Parenteral nutrition

TBD:

Total daily basal insulin dose

TDD:

Total daily insulin dose

TFD:

Total daily food-related insulin dose

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Author information

Authors and Affiliations

  1. USS Dietologia Clinica, Azienda Ospedaliera “Papa Giovanni XXIII”, Piazza OMS, 1, 24127, Bergamo, Italy

    Fiorenzo Cortinovis & Ottavia Colombo

  2. USC Endocrinologia, Azienda Ospedaliera “Papa Giovanni XXIII”, Piazza OMS, 1, 24127, Bergamo, Italy

    Sara Cassibba

Authors
  1. Fiorenzo Cortinovis
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  2. Sara Cassibba
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  3. Ottavia Colombo
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Corresponding author

Correspondence to Fiorenzo Cortinovis .

Editor information

Editors and Affiliations

  1. Department of Nutrition, King's College London, London, United Kingdom

    Rajkumar Rajendram

  2. School of Medicine, King's College London, London, United Kingdom

    Victor R. Preedy

  3. Department of Biomedical Sciences, University of Westminster, London, United Kingdom

    Vinood B. Patel

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Cortinovis, F., Cassibba, S., Colombo, O. (2014). Blood Glucose Control in Enteral Nutrition: Strategy for the Treatment of Hyperglycemia in Patients Receiving Enteral Nutrition. In: Rajendram, R., Preedy, V., Patel, V. (eds) Diet and Nutrition in Critical Care. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-8503-2_9-1

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  • DOI: https://doi.org/10.1007/978-1-4614-8503-2_9-1

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  • Publisher Name: Springer, New York, NY

  • Online ISBN: 978-1-4614-8503-2

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