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Chapter 6
Glycemic Control in the Setting of Parenteral Nutrition or Enteral Nutrition via Tube Feeding
Cecilia C. Low Wang, MD,1 R. Matthew Hawkins, PA-C, MMSc,2 Roma Gianchandani, MD,3 and Kathleen Dungan, MD4
1Associate Professor of Medicine/Director, Glucose Management Team University of Colorado School of Medicine/University of Colorado Hospital Aurora, CO. 2Physician Assistant/Instructor, Department of Endocrinology, Diabetes, and Metabolism, University of Colorado School of Medicine Anschutz Medial Campus, Aurora CO. 3Associate Professor, Department of Internal medicine/Metabolism, Endocrinology and Diabetes Director, Hospital Hyperglycemia Program University of Michigan Medical Center, Ann Arbor, MI. 4Ohio State University, Wexner Medical Center, Columbus, OH.
DOI: 10.2337/9781580406086.06
Introduction
Parenteral nutrition (PN) and enteral nutrition (EN) via tube feeding (TF) are used both within and outside the hospital setting to provide nutrition in individuals who are not able to eat via the traditional oral route because of various factors, including recovery from major abdominal surgery, critical illness, malabsorption, dysphagia, decreased level of consciousness, oropharyngeal processes, and esophageal dysmotility. The incidence of hyperglycemia with or without diagnosed diabetes in patients receiving EN via TF is unclear, but it may range from 34 to 50%.1 For hospitalized patients receiving PN, the prevalence of hyperglycemia ranges from 28 to