Traditional screening and assessment tools did not uniformly identify patients as malnourished or at nutrition risk in the ICU and therefore may be inappropriate for use in this population. Inclusion of physical assessment, functional status, and severity of illness may be useful in predicting nutrition risk in the ICU.

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A total of 1388 patients were started on PN. After adjusting for potential confounders, strong associations existed between PN insulin requirements and diabetes mellitus (DM) diagnosis (OR, 8.90; 95% CI, 4.98-15.90, P < .001), overweight/obese status (body mass index ≥25.0 kg/m(2)) (OR, 2.12; 95% CI, 1.04-4.30, P = .04), intensive care unit (ICU) admission (OR, 1.79; 95% CI, 1.03-3.11, P = .04), blood glucose (BG) on day of PN start >120 mg/dL (OR, 2.32; 95% CI, 1.32-4.05, P = .003), mean BG >180 mg/dL while receiving PN (OR, 6.10; 95% CI, 2.18-17.04, P = .001), and hemoglobin A1c (A1c) ≥5.7% (OR, 3.18; 95% CI, 1.84-5.50, P < .001). Among variables available at PN initiation, DM diagnosis (P < .001), A1c ≥5.7% (P < .001), BG >120 mg/dL on PN start day (P < .001), and ICU admission (P < .001) predicted the need for PN insulin.

It is the position of the Academy of Nutrition and Dietetics that, based upon current evidence, the Malnutrition Screening Tool should be used to screen adults for malnutrition (undernutrition) regardless of their age, medical history, or setting. Malnutrition (undernutrition) screening is a simple process intended to quickly recognize individuals who may have a malnutrition diagnosis. While numerous malnutrition screening tools are in use, their levels of validity, agreement, reliability, and generalizability vary. The Academy of Nutrition and Dietetics reviewed the body of evidence supporting malnutrition screening tools and determined a single tool for identifying adults in all settings who may have malnutrition, regardless of their age or medical history. The Nutrition Screening for Adults Workgroup conducted a systematic review of the most robust evidence to promote using the highest-quality malnutrition screening tool available.

The purpose of this cross-sectional study was to evaluate the diet quality of a sample of individuals with type 2 diabetes, using the Healthy Eating Index 2005, and to determine differences in total and component scores among clinical and demographic characteristics. Participants were recruited from clinics at a large, urban medical center. Each participant (n = 99) completed three to four 24-hour recalls and a demographics questionnaire. Foods were converted to MyPyramid servings to create Healthy Eating Index 2005 scores (mean ± SD = 56.3 ± 10.2). The mean Healthy Eating Index 2005 score of the sample was 56.3 (n = 99). Older adults had significantly higher scores than adults 40 to 60 years of age, and individuals classified as food secure had significantly higher scores than those classified as the food insecure. Clinicians should place further emphasis on inclusion of dark green and orange vegetables and legumes, whole grains, and dairy and exclusion of items high in sodium, saturated fat, solid fat, alcohol, and added sugars. Individuals with low food security may require additional education to comply with nutrition guidelines.

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