Blood glucose control: Strategy for treatment of hyperglycemia in patients receiving enteral nutrition

Abstract

Enteral nutrition is the main way to administer artificial nutrition to patients. It should be preferred to parenteral nutrition in all subjects whose gastroenteric tract is both anatomically and functionally undamaged. Enteral nutrition administration to diabetic patients, mainly those hospitalized in intensive care unit, is sometimes problematic because of the difficulties in managing glycemic control, due to the presence of insulin resistance which is always associated with acute illnesses. Several diabetes-specific enteral formulas are available in order to improve glycemic control. However, they do not receive unanimous approval from scientific societies committed to artificial nutrition. To date no specific guidelines exist for the insulinization of diabetic patients receiving enteral nutrition. This chapter supplies readers with recommendations concerning different insulinization strategies in diabetic patients as regards both the enteral nutrition induction and the subsequent enteral nutrition maintenance.