Enteral and Parenteral Nutrition with Diabetes

Czech version

Authors: L. Sobotka
Authors‘ workplace: Klinika gerontologická a metabolická Lékařské fakulty UK a FN Hradec Králové, přednosta prof. MUDr. Luboš Sobotka, CSc.
Published in: Vnitř Lék 2009; 55(4): 354-356
Category:

Overview

In type I diabetes insulin must be administered during nutritional support. The method of insulin administration is dependent on the clinical situation, presence of inflammation, method of nutrition delivery (enteral or parenteral) and other conditions. In type II diabetic patients oral drug treatment should be stopped in stress conditions. Obese type II diabetic patients often profit from hypocaloric nutrition but only when they are stable and any acute inflammatory illness has passed. This may improve their condition before elective procedures. However, strict monitoring of these patients is necessary in both types of diabetes mellitus.

Key words:
diabetes mellitus – enteral nutrition – parenteral nutrition – insulin

Sources

1. Clement S, Braithwaite SS, Ahmann A et al. Management of diabetes and hyperglycemia in hospitals. Diabetes Care 2004; 27: 553–591.

2. McMahon MM. Management of parenteral nutrition in acutely ill patients with hyperglycemia. Nutr Clin Pract 2004; 19: 120–128.

3. Pickup J, Keen H. Continuous Subcutaneous Insulin Infusion at 25 Years: Evidence base for the expanding use of insulin pump therapy in type 1 diabetes. Diabetes Care 2002; 25: 593–598.

4. Fatati G, Mirri E, Del Tosto S et al. Use of insulin glargine in patients with hyperglycaemia receiving artificial nutrition. Acta Diabetol 2005; 42: 182–186.

5. Christianson MA, Schwartz MW, Suzuki N. Determinants of insulin availability in parenteral nutrition solutions. JPEN 2006; 30: 6–9.

6. McCowen KC, Friel C, Sternberg J et al. Hypocaloric total parenteral nutrition: effectiveness in prevention of hyperglycemia and infectious complications – a randomized clinical trial. Crit Care Med 2000; 28: 3606–3611.

7. Van den Berghe G, Wouters P, Weekers F et al. Intensive insulin therapy in critically ill patients. N Engl J Med 2001; 345: 1359–1367.

8. Van den Berghe G, Wilmer A, Milants I et al. Intensive insulin therapy in mixed medical/surgical intensive care units: benefit versus harm. Diabetes 2006; 55: 3151–3159.