Article: Safety and Efficacy of Insulins in Critically Ill Patients Receiving Continuous Enteral Nutrition.
2024 Volume 30, Issue 4, Page(s) 367–371
Abstract: Objective: There is a relative lack of consensus regarding the optimal management of hyperglycemia in patients receiving continuous enteral nutrition (EN), with or without a diagnosis of diabetes.: Methods: This retrospective study examined 475 ... ...
Abstract | Objective: There is a relative lack of consensus regarding the optimal management of hyperglycemia in patients receiving continuous enteral nutrition (EN), with or without a diagnosis of diabetes. Methods: This retrospective study examined 475 patients (303 with known diabetes) hospitalized in critical care setting units in 2019 in a single center who received continuous EN. Rates of hypoglycemia, hyperglycemia, and glucose levels within the target range (70-180 mg/dL) were compared between patients with and without diabetes, and among patients treated with intermediate-acting (IA) biphasic neutral protamine Hagedorn 70/30, long-acting (LA) insulin, or rapid-acting insulin only. Results: Among those with type 2 diabetes mellitus, IA and LA insulin regimens were associated with a significantly higher proportion of patient-days in the target glucose range and fewer hyperglycemic days. Level 1 (<70 mg/dL) and level 2 (<54 mg/dL) hypoglycemia occurred rarely, and there were no significant differences in level 2 hypoglycemia frequency across the different insulin regimens. Conclusion: Administration of IA and LA insulin can be safe and effective for those receiving insulin doses for EN-related hyperglycemia. |
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MeSH term(s) | Humans ; Diabetes Mellitus, Type 2/drug therapy ; Hypoglycemic Agents/adverse effects ; Retrospective Studies ; Enteral Nutrition ; Critical Illness/therapy ; Blood Glucose ; Insulin/adverse effects ; Hypoglycemia/chemically induced ; Hypoglycemia/epidemiology ; Hypoglycemia/drug therapy ; Insulin, Long-Acting/therapeutic use ; Hyperglycemia/drug therapy ; Hyperglycemia/prevention & control ; Hyperglycemia/chemically induced ; Glucose/therapeutic use ; Insulin, Isophane/adverse effects |
Chemical Substances | Hypoglycemic Agents ; Blood Glucose ; Insulin ; Insulin, Long-Acting ; Glucose (IY9XDZ35W2) ; Insulin, Isophane (53027-39-7) |
Language | English |
Publishing date | 2024-02-01 |
Publishing country | United States |
Document type | Journal Article |
ZDB-ID | 1473503-9 |
ISSN | 1530-891X |
ISSN | 1530-891X |
DOI | 10.1016/j.eprac.2024.01.009 |
Database | MEDical Literature Analysis and Retrieval System OnLINE |
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