Recommendations of the GARIN group for managing non-critically ill patients with diabetes or stress hyperglycaemia and artificial nutrition.

Abstract:

BACKGROUND & AIMS:By means of this update, the GARIN working group aims to define its position regarding the treatment of patients with diabetes or stress hyperglycaemia and artificial nutrition. In this area there are many aspects of uncertainty, especially in non-critically ill patients. METHODS:Bibliographical review, and specific questions in advance were discussed and answered at a meeting in the form of conclusions. RESULTS:We propose a definition of stress hyperglycaemia. The indications and access routes for artificial nutrition are no different in patients with diabetes/stress hyperglycaemia than in non-diabetics. The objective must be to keep pre-prandial blood glucose levels between 100 and 140 mg/dl and post-prandial levels between 140 and 180 mg/dl. Hyperglycemia can be prevented through systematic monitoring of capillary glycaemias and adequately calculate energy-protein needs. We recommend using enteral formulas designed for patients with diabetes (high monounsaturated fat) to facilitate metabolic control. The best drug treatment for treating hyperglycaemia/diabetes in hospitalised patients is insulin and we make recommendations for adapt the theoretical insulin action to the nutrition infusion regimen. We also addressed recommendations for future investigation. CONCLUSIONS:This recommendations about artificial nutrition in patients with diabetes or stress hyperglycaemia can add value to clinical work.

journal_name

Nutr Hosp

journal_title

Nutricion hospitalaria

authors

Olveira G,García-Luna PP,Pereira JL,Rebollo I,García-Almeida JM,Serrano P,Irles JA,Muñoz-Aguilar A,Molina MJ,Tapia MJ,GARIN Group Andalusian Group for Nutrition Reflection and Investigation.

doi

10.3305/nh.2012.27.6.6076

subject

Has Abstract

pub_date

2012-11-01 00:00:00

pages

1837-49

issue

6

eissn

0212-1611

issn

1699-5198

pii

S0212-16112012000600008

journal_volume

27

pub_type

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