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Risk factors for predicting hypoglycemia in patients receiving concomitant parenteral nutrition and insulin therapy.
MedLine Citation:
PMID:  23351630     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
The occurrence of hypoglycemia in patients receiving parenteral nutrition (PN) is low, yet its consequences can be detrimental. Treatment of hyperglycemia with insulin to achieve optimal blood glucose control is challenging and potentially associated with increased risk of the development of hypoglycemia. The objective of this study was to determine the association of patient characteristics on the risk of hypoglycemia among patients receiving concomitant PN and insulin therapy. This retrospective cohort study was conducted from January 1, 2008, to December 31, 2011, and included 1,657 patients who received PN. There was a significant decrease in the occurrence of hypoglycemia observed over time: 9.1% (43 of 475) in 2008, 6.4% (30 of 468) in 2009, 5.8% (20 of 347) in 2010, and 3.5% (13 of 367) in 2011 (P=0.013). Patients in whom hypoglycemia developed had a significantly longer duration on PN (18.0 vs 8.1 days, P<0.0001) as well as more days requiring insulin in the PN (16.1 vs 2.7 days, P<0.0001). The strongest predictors of hypoglycemia were: receiving PN in the ICU (OR 1.86, 95% CI 1.16 to 3.01), history of diabetes (OR 2.10, 95% CI 1.26 to 3.51), days on PN (OR 0.93, 95% CI 0.91 to 0.95), and an insulin drip (OR 3.14, 95% CI 1.81 to 5.42). With the identification of patient factors that contribute to an increase in hypoglycemia, existing protocols can be modified to treat hyperglycemia and prevent hypoglycemia.
Authors:
Kelly F Kinnare; Cheryl A Bacon; Yimin Chen; Diane C Sowa; Sarah J Peterson
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the Academy of Nutrition and Dietetics     Volume:  113     ISSN:  2212-2672     ISO Abbreviation:  J Acad Nutr Diet     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-01-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101573920     Medline TA:  J Acad Nutr Diet     Country:  United States    
Other Details:
Languages:  eng     Pagination:  263-8     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2013 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.
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