• Nutrition · Jan 2015

    Multicenter Study

    Hypoglycemia in noncritically ill patients receiving total parenteral nutrition: a multicenter study. (Study group on the problem of hyperglycemia in parenteral nutrition; Nutrition area of the Spanish Society of Endocrinology and Nutrition).

    • Gabriel Olveira, María José Tapia, Julia Ocón, Carmen Cabrejas-Gómez, María D Ballesteros-Pomar, Alfonso Vidal-Casariego, Carmen Arraiza-Irigoyen, Josefina Olivares, Maria Carmen Conde-García, Álvaro García-Manzanares, Francisco Botella-Romero, Rosa P Quílez-Toboso, Pilar Matía, Miguel Ángel Rubio, Luisa Chicharro, Rosa Burgos, Pedro Pujante, Mercedes Ferrer, Ana Zugasti, Estrella Petrina, Laura Manjón, Marta Diéguez, Ma José Carrera, Anna Vila-Bundo, Juan Ramón Urgelés, Carmen Aragón-Valera, Olga Sánchez-Vilar, Irene Bretón, Pilar García-Peris, Araceli Muñoz-Garach, Efren Márquez, Dolores Del Olmo, José Luis Pereira, and María C Tous.
    • Unidad de Gestión Clínica de Endocrinología y Nutrición, IBIMA, Hospital Regional Universitario de Málaga/Universidad de Málaga, Malaga, Spain; CIBERDEM, CIBER of Diabetes and Associated Metabolic Diseases (CB07/08/0019), Instituto de Salud Carlos III, Madrid, Spain. Electronic address: gabrielm.olveira.sspa@juntadeandalucia.es.
    • Nutrition. 2015 Jan 1;31(1):58-63.

    ObjectiveHypoglycemia is a common problem among hospitalized patients. Treatment of hyperglycemia with insulin is potentially associated with an increased risk for hypoglycemia. The aim of this study was to determine the prevalence and predictors of hypoglycemia (capillary blood glucose <70 mg/dL) in hospitalized patients receiving total parenteral nutrition (TPN).MethodsThis prospective multicenter study involved 19 Spanish hospitals. Noncritically ill adults who were prescribed TPN were included, thus enabling us to collect data on capillary blood glucose and insulin dosage.ResultsThe study included 605 patients of whom 6.8% (n = 41) had at least one capillary blood glucose <70 mg/dL and 2.6% (n = 16) had symptomatic hypoglycemia. The total number of hypoglycemic episodes per 100 d of TPN was 0.82. In univariate analysis, hypoglycemia was significantly associated with the presence of diabetes, a lower body mass index (BMI), and treatment with intravenous (IV) insulin. Patients with hypoglycemia also had a significantly longer hospital length of stay, PN duration, higher blood glucose variability, and a higher insulin dose. Multiple logistic regression analysis showed that a lower BMI, high blood glucose variability, and TPN duration were risk factors for hypoglycemia. Use of IV insulin and blood glucose variability were predictors of symptomatic hypoglycemia.ConclusionsThe occurrence of hypoglycemia in noncritically ill patients receiving PN is low. A lower BMI and a greater blood glucose variability and TPN duration are factors associated with the risk for hypoglycemia. IV insulin and glucose variability were predictors of symptomatic hypoglycemia.Copyright © 2015 Elsevier Inc. All rights reserved.

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