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. 2015;43(2):74-8.
doi: 10.1080/21548331.2015.1022493. Epub 2015 Mar 6.

Managing hyperglycemia and diabetes in patients receiving enteral feedings: A health system approach

Melanie E Mabrey  1 , Anna Beth Barton, Leonor Corsino, Susan B Freeman, Ellen D Davis, Elizabeth L Bell, Tracy L Setji
Affiliations

Managing hyperglycemia and diabetes in patients receiving enteral feedings: A health system approach

Melanie E Mabrey et al. Hosp Pract (1995). 2015.

Erratum in

  • Erratum.
    [No authors listed] [No authors listed] Hosp Pract (1995). 2015;43(5):308. doi: 10.1080/21548331.2015.1071727. Hosp Pract (1995). 2015. PMID: 26691670 No abstract available.

Abstract

Evidence of poor outcomes in hospitalized patients with hyperglycemia has led to new and revised guidelines for inpatient management of diabetes. As providers become more aware of the need for better blood glucose control, they are finding limited guidance in the management of patients receiving enteral nutrition. To address the lack of guidelines in this population, Duke University Health System has developed a consistent practice for managing such patients. Here, we present our practice strategies for insulin use in patients receiving enteral nutrition. Essential factors include assessing the patients' history of diabetes, hyperglycemia, or hypoglycemia and timing and type of feedings. Insulin practices are then designed to address these issues keeping in mind patient safety in the event of abrupt cessation of nutrition. The outcome of the process is a consistent and safe method for glucose control with enteral nutrition.

Keywords: Enteral nutrition; diabetes; hyperglycemia; inpatient; nocturnal nutrition; tube feeding.

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Figures

Figure 1
Figure 1
Determining TDD of insulin. Abbreviations: CrCl = Creatinine clearance; TDD = Total daily dose.
Figure 2
Figure 2
Formula for transitioning patients from continuous to cyclic or nocturnal enteral nutrition. Abbreviation: TDD = Total daily dose.
Figure 3
Figure 3
D10 algorithm for interrupted tube feedings for adults.
See this image and copyright information in PMC

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