Improved Glucose Profile in Patients With Type 2 Diabetes With a New, High‐Protein, Diabetes‐Specific Tube Feed During 4 Hours of Continuous Feeding

Lansink, Mirian; Hofman, Zandrie; Genovese, Stefano; Rouws, C.; Ceriello, Antonio

doi:10.1177/0148607115625635

Cited by 16 publications

(16 citation statements)

References 49 publications

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“…Reduction in length of stay and cost was associated with use of diabetic products, but this study has been criticized for its methodology of basing its results on billed products and not on the amounts actually administered. In another study, nonhospitalized persons received 4 continuous hours of tube feeding, comparing a diabetic formula with a standard product; the diabetic product resulted in lower glucose and insulin levels 54 . However, 4 hours of continuous tube feeding does not reflect a typical home tube feeding, so conclusions really cannot be made from this study.…”

Section: Disease‐specific Formulasmentioning

confidence: 84%

Enteral Formulas in Nutrition Support Practice

Escuro

Hummell

2016

Nut in Clin Prac

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Over the past few decades, the number of enteral formulas for use in hospitalized, critically ill, and home enteral patients has dramatically increased. Several enteral nutrition (EN) formula categories exist, which makes it challenging for clinicians to sort through the product claims and find the appropriate formula for the patient. Many formulas are available within each category, some of which may be significantly different from one another. Numerous systematic reviews of existing research and clinical practice guidelines evaluate the use of specialty formulas. This review aims to examine the differences in various enteral formula categories, identify applications in clinical practice, and evaluate the existing evidence and guideline recommendations for use of specific types of enteral formulas.

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Section: Disease‐specific Formulasmentioning

confidence: 84%

Enteral Formulas in Nutrition Support Practice

Escuro

Hummell

2016

Nut in Clin Prac

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“…18 o momento. 8,21 Uma das limitações deste estudo foi a não verificação de quais pacientes utilizaram realmente insulina, foram registrados o tipo e a dose prescrita, mas não se sabe ao certo em quais pacientes ela foi aplicada, já que é utilizada se necessário e não é registrada no sistema virtual do hospital. Outra limitação foi a carência de indicadores de gravidade, já que a gravidade da doença gera um acelerado processo metabólico e a utilização desses indicadores é de grande valia em uma UTI.…”

Section: Discussionunclassified

Relação entre o estado nutricional, nutrição precoce, hiperglicemia e desfecho clínico de pacientes internados em uma unidade de terapia intensiva

Fischer

Poll

2019

Rev Epidemiol Control Infect

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Justificativa e Objetivos: A oferta de nutrientes no momento certo, pode minimizar os efeitos do catabolismo exacerbado, melhorando a evolução clínica do paciente. Por isso, o objetivo deste estudo foi avaliar e relacionar o estado nutricional, nutrição precoce e hiperglicemia com o desfecho clínico de pacientes críticos internados em uma unidade de terapia intensiva. Métodos: Trata-se de um estudo de coorte prospectivo, com pacientes críticos de um hospital do interior do estado do Rio Grande do Sul, de ambos os sexos, com idade superior a 20 anos. Foram coletadas informações como, doença (s) de base, diagnóstico principal, idade, sexo, data de internação, tipo e tempo de terapia nutricional instituída, via de administração da dieta, avaliação da glicemia, aplicação de insulina, complicações clínicas, dias de internação e o desfecho clínico. A glicemia e a via de dieta foram acompanhadas durante 72 horas de internação. Resultado: Participaram do estudo 66 pacientes, com média de 64,08±16,11 anos, 59,1% eram do sexo masculino, houve predomínio de sobrepeso (59,1%) e 48,5% internaram por algum evento cardiovascular. Nas 24 horas de internação 15,2% dos indivíduos eram hiperglicêmicos, seguido de 21,2% nas 48 horas e 19,7% nas 72 horas. Verificamos associação entre o desfecho clínico dos pacientes e a nutrição precoce em até 48 horas (p=0,004), assim como, infecção (p=0,036) e os tipos de vias alimentares utilizadas nas primeiras 48 horas (p=0,002) e em até 72 horas (p=0,001). Conclusão: A terapia nutricional precoce influencia diretamente no desfecho clínico de pacientes críticos, apresentando-se como um risco à vida. Descritores: Hiperglicemia. Estado nutricional. Suporte nutricional. Unidades de terapia intensiva.

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“…These data show that different insulin regimens may be used in tube‐fed patients with DM: long‐acting insulin (glargine) alone, NPH ×3, biphasic insulin 70/30 ×2 or ×3, or combination of short‐acting and long‐acting insulin analogues. Several options may be applied to improve glycemic control in these patients: the use of a diabetes‐specific formula (high‐protein formulations) was positively evaluated in a systematic review of randomized controlled trials (RCTs), 20 and more recent studies in critically ill 21 and ambulatory nonhospitalized patients 22 were also promising. The involvement of a “specialist diabetes team” in the management of these patients also had a positive impact on glycemic control in 1 study 23 .…”

Section: Discussionmentioning

confidence: 99%

Retrospective Evaluation of Glycemic Control With Basal‐Bolus or Neutral Protamine Hagedorn Insulin Regimens in Patients Receiving Continuous Enteral Nutrition Therapy in Medicine Wards

Hijaze

Szalat

2017

Nut in Clin Prac

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Reasonable glycemic control is difficult to achieve in patients with diabetes mellitus (DM) receiving continuous enteral nutrition therapy (CENT). There are no solid evidence-based medicine guidelines regarding this issue in these patients. The purpose of this study was to determine if the use of a basal-bolus insulin regimen is more effective than neutral protamine Hagedorn (NPH) insulin alone in controlling blood glucose in non-critically ill patients with DM receiving CENT. We performed a retrospective, records-based review comparing basal-bolus with NPH insulin regimen in these patients, hospitalized in the internal medicine wards in our hospital. Number of hypoglycemic episodes, mean blood glucose, and time-to-target (time needed to reach 3 successive glucose readings in the appropriate target of 140-180 mg/dL) were evaluated in each regimen. Mean blood glucose was 199.22 mg/dL (95% confidence interval [CI], 179.8-218.5 mg/dL) in the basal-bolus vs 190.73 mg/dL (95% CI, 172.1-209.2 mg/dL) in the NPH insulin regimen ( P = .538). Time-to-target was an average of 3.65 ± 1.75 days in the basal-bolus group and 4.33 ± 2.42 days in the NPH group ( P = .364). There were no statistically significant differences in frequency of hypoglycemia ( P = .364). Rate of death was high (around 40%) in both groups. We conclude that hospitalized hyperglycemic patients receiving CENT can be treated by either basal-bolus or NPH insulin regimens. However, the overall glucose levels remain elevated during hospitalization irrespective of the insulin therapy. There is an urgent need to define glucose targets in this population of patients and to evaluate prospectively head-to-head different insulin protocols.

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Improved Glucose Profile in Patients With Type 2 Diabetes With a New, High‐Protein, Diabetes‐Specific Tube Feed During 4 Hours of Continuous Feeding

Cited by 16 publications

References 49 publications

Enteral Formulas in Nutrition Support Practice

Enteral Formulas in Nutrition Support Practice

Relação entre o estado nutricional, nutrição precoce, hiperglicemia e desfecho clínico de pacientes internados em uma unidade de terapia intensiva

Retrospective Evaluation of Glycemic Control With Basal‐Bolus or Neutral Protamine Hagedorn Insulin Regimens in Patients Receiving Continuous Enteral Nutrition Therapy in Medicine Wards

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