825-P: Glycemic Control in Hospitalized Patients Receiving Enteral Nutrition

Abstract

Objective: The incidence of hyperglycemia in patients receiving enteral nutrition ranges from 34.5-50% and is associated with increased morbidity and mortality. This study examined glycemic control in hospitalized patients receiving enteral nutrition on insulin therapy. Methods: Admission level data for all adults (18 years or older) admitted to UC Health Central from Jan 1-Dec 31, 2019 treated with insulin while receiving continuous enteral nutrition were included. Patients were stratified by any pre-existing diagnosis of diabetes mellitus (DM) determined from diagnosis codes prior to the admission date. Blood glucose values from point of care testing performed up to 10 days while receiving enteral nutrition and insulin were included. Results: A total of 662 patients accounted for 789 admissions in 2019 during which enteral nutrition and insulin were received. For each admission, the longest period of continuous tube feeding up to 10 days was selected, for a total of 5443 days for which data are available. Of the 662 patients, 348 (52.5%) had pre-existing DM (mean±SD 61.5±13.1 years) and 314 (47.4%) did not (mean±SD age 58.2 ±15.2 years); 260 (39.3%) were female and 402 (60.7%) were male. The glucose on days 2, 6, and 10 of enteral nutrition and insulin were 168.3±51.9, 160.1±41.1, and 153.4±38.6 mg/dL, respectively (n=621, 426, and 284 for respective days).. The percentage of inpatient days with a blood glucose value < 70 mg/dL in patients without DM was 2.8% vs. 5.3% in patients with DM (p<0.0001). Conclusion: Mean glucose improved and variability decreased over time in hospitalized patients with or without diabetes on enteral nutrition and insulin therapy, but the mean glucose was within the goal range of 140-180 mg/dL. Patients without a prior diagnosis of diabetes had a lower percentage of inpatient days with a BG < 70 mg/dL. Further analysis is needed to determine optimal insulin dosing strategies and to improve glycemic control in this population. Disclosure R. Hawkins: None. S. A. Seggelke: None. J. Gibbs: None. M. C. Lindsay: None. C. C. Low wang: None.