Hyperglycemia-related risk factors in enteral nutrition in non-critically ill patients

Carbohydrate metabolism can change in hospitalized patients due to stress, or the use of enteral nutrition (EN). The aim of this study was to determine the risk factors triggering these changes.

We conducted a retrospective observational study in non-diabetic patients with low levels of stress on EN. Five groups were categorized based on changes to the metabolism of hydrocarbons produced before or after EN: plasma glycemia prior to EN >126mg/dL (stress hyperglycemia - SH) (35.1%); plasma glycaemia prior to EN <126mg/dL (non-HE) (64.89%). Hyperglycemia with EN (HyperEN): at least, two capillary blood glucose readings >140mg/dL or 1 >180mg/dL during EN (71%); non-HyperEN: capillary blood glucose readings with EN <140mg/dL (29%).

A total of 131 patients were included (45.8% men) with a median age of 81 (71-87) years. A total of 52 patients exceeded 180mg/dL at one measurement, and 24 patients required insulin detemir with a median of 16 (12-27) IU per day. Risk factors for HyperEN were identified as patient age (OR, 1.186; 95% CI, 1.051-1.341; p<0.01) and duration of nutritional treatment (OR, 1.320; 95% CI, 1.086-1.605; p<0.01).

Our study shows a high prevalence of carbohydrate metabolism disorders in hospitalized patients on total EN, with age and duration of nutritional treatment being the main risk factors.