Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2013 Feb;13(1):155-62.
doi: 10.1007/s11892-012-0335-y.

Management of hyperglycemia during enteral and parenteral nutrition therapy

Aidar R Gosmanov  1 , Guillermo E Umpierrez
Affiliations
Review

Management of hyperglycemia during enteral and parenteral nutrition therapy

Aidar R Gosmanov et al. Curr Diab Rep. 2013 Feb.

Abstract

Hyperglycemia is a frequent complication of enteral and parenteral nutrition in hospitalized patients. Extensive evidence from observational studies indicates that the development of hyperglycemia during parenteral and enteral nutrition is associated with an increased risk of death and infectious complications. There are no specific guidelines recommending glycemic targets and effective strategies for the management of hyperglycemia during specialized nutritional support. Managing hyperglycemia in these patients should include optimization of carbohydrate content and administration of intravenous or subcutaneous insulin therapy. The administration of continuous insulin infusion and insulin addition to nutrition bag are efficient approaches to control hyperglycemia during parenteral nutrition. Subcutaneous administration of long-acting insulin with scheduled or corrective doses of short-acting insulin is superior to the sliding scale insulin strategy in patients receiving enteral feedings. Randomized controlled studies are needed to evaluate safe and effective therapeutic strategies for the management of hyperglycemia in patients receiving nutritional support.

PubMed Disclaimer

Conflict of interest statement

Disclosure No potential conflicts of interest relevant to this article were reported.

Figures

Fig. 1
Fig. 1
Approach to the management of hyperglycemia in patients receiving enteral or parenteral nutrition. POC—point of care; BG— blood glucose; EN—enteral nutrition; PN—parenteral nutrition; DM— diabetes mellitus
See this image and copyright information in PMC

References

    1. Umpierrez GE, Hellman R, Korytkowski MT, et al. Management of hyperglycemia in hospitalized patients in non-critical care setting: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2012;97:16–38. These guidelnies represent the most up to date recommendations on management of hyperglycemia in hospitalized non-critically ill patients.

    1. Cook CB, Kongable GL, Potter DJ, et al. Inpatient glucose control: a glycemic survey of 126 U.S. hospitals. J Hospital Med. 2009;4:E7–E14. - PubMed
    1. Umpierrez GE, Isaacs SD, Bazargan N, et al. Hyperglycemia: an independent marker of in-hospital mortality in patients with undiagnosed diabetes. J Clin Endocrinol Metab. 2002;87:978–982. - PubMed
    1. Jiang HJ, Stryer D, Friedman B, Andrews R. Multiple hospitalizations for patients with diabetes. Diabetes Care. 2003;26:1421–1426. - PubMed
    1. Pleva M, Mirtallo JM, Steinberg SM. Hyperglycemic events in non-intensive care unit patients receiving parenteral nutrition. Nutr Clin Pract. 2009;24:626–634. - PubMed