Comparison of the Effects of Standard and Diabetesspecific Dietary Products on Tight Blood Glucose Control in Critically Ill Patients
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Original Research
P: 139-145
September 2020

Comparison of the Effects of Standard and Diabetesspecific Dietary Products on Tight Blood Glucose Control in Critically Ill Patients

J Turk Soc Intens Care 2020;18(3):139-145
1. İstanbul Medipol Üniversitesi Tıp Fakültesi, Anesteziyoloji ve Reanimasyon Anabilim Dalı, İstanbul, Türkiye
2. İstanbul Medipol Üniversitesi Tıp Fakültesi, Anesteziyoloji ve Reanimasyon Anabilim Dalı, İstanbul, Türkiye
3. İstanbul Üniversitesi Cerrahpaşa, Cerrahpaşa Tıp Fakültesi, Anesteziyoloji ve Reanimasyon Anabilim Dalı, Yoğun Bakım Bilim Dalı, İstanbul, Türkiye
4. Yeditepe Tıp Fakültesi, Anesteziyoloji ve Reanimasyon Anabilim Dalı, İstanbul, Türkiye
5. İstanbul Üniversitesi-Cerrahpaşa Cerrahpaşa Tıp Fakültesi, Anesteziyoloji ve Reanimasyon Anabilim Dalı, Yoğun Bakım Bilim Dalı, İstanbul, Türkiye
6. Yeditepe Üniversitesi Tıp Fakültesi, Anesteziyoloji ve Reanimasyon Anabilim Dalı, İstanbul, Türkiye
No information available.
No information available
Received Date: 10.05.2019
Accepted Date: 26.08.2019
Publish Date: 11.09.2020
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ABSTRACT

Objective:

Nutritional support is a part of intensive care unit therapy. In our study, we investigated the effects of diabetes-specific enteral formula and standard enteral formula on tight blood glucose control and insulin requirement in hyperglycemic intensive care unit patients.

Materials and Methods:

The study was planned as a prospective, randomized, crossover comparative study. The daily caloric requirements for patients who tolerated enteral product intake were calculated as 25 kcal x body weight. Calorie requirements were divided into 21 hours and hourly calorie needs and nutrient volume were calculated. Eighty patients were divided into two groups. First group received ISOSOURCE® Standard and second group received Novasource® Diabetes in the first 24 hours. In the second 24 hours, group 1 received Novasource® Diabetes, while Group 2 received Isosource® Standard. An intravenous insulin infusion was given to maintain the blood glucose level at 80-150 mg/dL. Blood glucose level was measured every 4 hours by taking arterial blood gas. Maximum, minimum, mean and median blood glucose levels, total insulin, mean insulin levels and the number of insulin dose changes were recorded.

Results:

No statistically significant difference was observed between two groups in terms of maximum, minimum and mean blood glucose levels. When compared, median blood glucose levels were numerically significant, but were not statistically significant in both groups.

Conclusion:

It was concluded that diabetes-specific enteral formula did not contribute significantly to tight blood glucose control in non-diabetic critical patients.

Keywords: Glucose, hyperglycemia, insulin, nutrition

References

1
Moral AR, Demirağ K. Yoğun bakımda beslenme. In: Tüzüner F, editör. Anestezi yoğun bakım ağrı. 1. Baskı. Ankara: MN Medikal & Nobel; 2010. s. 1487-95.
2
Mesejo A, Acosta JA, Ortega C, Vila J, Fernandez M, Ferreres J et al. Comparison of a high- protein disease- spesific enteral formula with a high- protein enteral formula in hyperglycemic critically ill patients. Clinical Nutrition 2003;22:295-305.
3
Van den Berghe G, Wouters P, Weekers F, Verwaest C, Bruyninckx F, Schetz M, et al. Intensive insulin therapy in critically ill patients. N Engl J Med 2001;345:1359-67.
4
McMahon MM, Miles JM. Glycemic control and nutrition in the intensive care unit. Current Opinion in Clinical Nutrition and Metabolic Care 2006;9:120-3.
5
Van den Berghe G, Wilmer A, Hermans G, Meersseman W, Wouters PJ, Milants I et al. Intensive insulin therapy in the medical ICU. N Engl J Med 2006;354:449-61.
6
VISEP: Brunkhorst FM, Engel C, Bloos F, Meier-Hellmann A, Ragaller M, Weiler N et al. German Competence Network Sepsis (SepNet): Intensive insulin therapy and pentastarch resuscitation in severe sepsis. N Engl J Med 2008;358:125-39.
7
Preiser JC, Devos P, Ruiz-Santana S, Me´lot C, Annane D, Groeneveld J et al. A prospective randomised multi-centre controlled trial on tight glucose control by intensive insulin therapy in adult intensive care units: The Glucontrol study. Intensive Care Med 2009;35:1738-48.
8
NICE-SUGAR: Finfer S, Chittock DR, Su SY, Blair D, Foster D, Dhingra V ve ark. Intensive versus conventional glucose control in critically ill patients. N Engl J Med 2009;360:1346-9.
9
Joseph B, Genaw J, Carlin A, Jordan J, Talley J, Rubinfeld I. Perioperative tight glycemic control: The challenge of bariatric surgery patients and the fear of hypoglycemic events. The Permanente Journal Spring 2007;11:2.
10
Patel GW, Roderman N, Lee KA, Charles MM, Nguyen D, Beougher P, et al. Sliding scale versus tight glycemic control in the noncritically ill at a community hospital. Ann Pharmacother 2009;43:1774-80.
11
Peters A, Davidson M, Isaac RM. Lack of glucose elevation after simulated tube feeding with a low-carbohydrate, high-fat enteral formula in patients with type I diabetes. Am J Med 1989;87:178-82.
12
Grahm TW, Zadrozny DB, Harrington T. The benefits of early jejunal hyperalimentation in the head-injured patient. Neurosurgery 1989;25:729-35.
13
Elia N, Ceriello A, Laube H, Sinclair AJ, Engfer M, Stratton RJ. Enteral nutritional support and use of diabetes-spesific formulas for patients with diabetes: a systematic review and meta-analysis. Diabetes Care 2005;28:2267-79.
14
Yokoyama J, Someya Y, Yoshihara, Ishii H. Effects of high-monounsaturated fatty acid enteral formula versus high-carbohydrate enteral formula on plasma glucose concentration and insulin secretion in healthy individuals and diabetic patients. The Journal of International Medical Research 2008;36:137-46.
15
Gunst J, De Bruyn A, Van den Berghe G. Glucose control in the ICU. Curr Opin Anesthesiol 2019;32:156-62.
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