• Study Group Of Hyperglycemia In Parenteral Nutrition Nutrition Area Of The Spanish Society Of Endocrinology And Nutrition Seen, Gabriel Olveira, María J Tapia, Julia Ocón, Carmen Cabrejas-Gómez, María D Ballesteros-Pomar, Alfonso Vidal-Casariego, Carmen Arraiza-Irigoyen, Josefina Olivares, María C Conde-García, Álvaro García-Manzanares, Francisco Botella-Romero, Rosa P Quílez-Toboso, Lucio Cabrerizo, Pilar Matía, Luisa Chicharro, Rosa Burgos, Pedro Pujante, Mercedes Ferrer, Ana Zugasti, Estrella Petrina, Laura Manjón, Marta Diéguez, María J Carrera, Anna Vila-Bundo, Juan R 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, Spain.
• Endocr Pract. 2015 Jan 1; 21 (1): 59-67.

ObjectiveThe prevalence of carbohydrate metabolism disorders in patients who receive total parenteral nutrition (TPN) is not well known. These disorders can affect the treatment, metabolic control, and prognosis of affected patients. The aims of this study were to determine the prevalence in noncritically ill patients on TPN of diabetes, prediabetes, and stress hyperglycemia; the factors affecting hyperglycemia during TPN; and the insulin therapy provided and the metabolic control achieved.MethodsWe undertook a prospective multicenter study involving 19 Spanish hospitals. Noncritically ill patients who were prescribed TPN were included, and data were collected on demographic, clinical, and laboratory variables (glycated hemoglobin, C-reactive protein [CRP], capillary blood glucose) as well as insulin treatment.ResultsThe study included 605 patients. Before initiation of TPN, the prevalence of known diabetes was 17.4%, unknown diabetes 4.3%, stress hyperglycemia 7.1%, and prediabetes 27.8%. During TPN therapy, 50.9% of patients had at least one capillary blood glucose of >180 mg/dL. Predisposing factors were age, levels of CRP and glycated hemoglobin, the presence of diabetes, infectious complications, the number of grams of carbohydrates infused, and the administration of glucose-elevating drugs. Most (71.6%) patients were treated with insulin. The mean capillary blood glucose levels during TPN were: known diabetes (178.6 ± 46.5 mg/dL), unknown diabetes (173.9 ± 51.9), prediabetes (136.0 ± 25.4), stress hyperglycemia (146.0 ± 29.3), and normal (123.2 ± 19.9) (P<.001).ConclusionThe prevalence of carbohydrate metabolism disorders is very high in noncritically ill patients on TPN. These disorders affect insulin treatment and the degree of metabolic control achieved.

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