Related Experiment Video
Updated: Jul 11, 2026

Improving IV Insulin Administration in a Community Hospital
Published on: June 11, 2012
The relationship between blood glucose control and intolerance to enteral feeding during critical illness
Nam Nguyen1, Katrina Ching, Robert Fraser
1Department of Gastroenterology, Hepatology and General Medicine, Royal Adelaide Hospital, North Terrace, Adelaide, 5000, Australia. quoc.nguyen@health.sa.gov.au
Objective:
To assess the relationship between blood glucose concentrations (BSL) and intolerance to gastric feeding in critically ill patients.
Design:
Prospective, case-controlled study.
Patients And Participants:
Two-hourly BSL and insulin requirements over the first 10 days after admission were assessed in 95 consecutive feed-intolerant (NG aspirate > 250 ml during feed) critically ill patients and 50 age-matched, feed-tolerant patients who received feeds for at least 3 days. Patients with diabetes mellitus were excluded. A standard insulin protocol was used to maintain BSL at 5.0-7.9 mmol.
Measurements And Results:
The peak BSLs were significantly higher before and during enteral feeding in feed-intolerant patients. The mean and trough BSLs were, however, similar between the two groups on admission, 24 h prior to feeding and for the first 4 days of feeding. The variations in BSLs over 24 h before and during enteral feeding were significantly greater in feed-intolerant patients. A BSL greater than 10 mmol/l was more prevalent in patients with feed intolerance during enteral feeding. The time taken to develop feed intolerance was inversely related to the admission BSL (r= -0.40). The amount of insulin administered before and during enteral feeding was similar between the two groups.
Conclusions:
Feed intolerance in critically ill patients is associated with a greater degree of glycaemic variation, with a greater number of patients with transient hyperglycaemia. These data suggest more intensive insulin therapy may be required to minimize feed intolerance, an issue that warrants further study.
Related Concept Videos
Enteral Nutrition II: Nasointestinal and Gastrostomy Feeding
Nasointestinal Feeding
Nasointestinal feeding involves placing a tube through...
Hypoglycemia and Glucagon
Hyperglycemia
Enteral Nutrition I: Orogastric and Nasogastric Feeding
Orogastric (OG) and nasogastric (NG) feeding are two standard methods used for enteral nutrition. Enteral nutrition is often preferred over...
Glucose Transporters
Facilitated diffusion-glucose transporters (GLUTs) are encoded by the solute-linked carrier (SLC) family 2, subfamily A gene family, or SLC2A. The 14 GLUT protein members are distributed into three classes:
Overview of Carbohydrate Metabolism
Glucose transport into cells is facilitated by a family of transport proteins called GLUT (Glucose Transporters). GLUT4 is the primary glucose transporter for insulin-stimulated glucose...