Do We Know What Our Patients With Diabetes Are Eating in the Hospital?

Abstract

Diabetes is one of the most prevalent diagnoses seen in hospitalized patients in the United States, accounting for ∼ 38% of all patients admitted to hospitals.1 Research on the benefits of glucose control in the hospital setting has focused primarily on critically ill cardiovascular patients.1–5 Hyperglycemia has been linked to immunosuppression, increased coagulapathies, increased infection rates, endothelial dysfunction, and prolonged lengths of hospitalizations.2,6 A diabetic population is at greater risk for developing complications if glucose levels are not controlled. Improved glycemic control is dependent on establishment of glycemic targets, adjustment of diabetes medication regimens (including insulin), monitoring of glucose trends, and assessment of eating behaviors. Accordingly, to understand glycemic control in the hospitalized population, it is important to examine meal consumption, as well as pharmacological therapies.7 Unfortunately, eating patterns and actual nutritional intake are not well understood for this population.2 Thus, the aim of this study was to explore meal consumption patterns of hospitalized patients with diabetes. The research questions included: 1. What is the average daily meal consumption of hospitalized patients with diabetes receiving subcutaneous insulin therapy? 2. Is there a difference between actual meal consumption and estimated nutritional requirements in hospitalized patients with diabetes? 3. What factors affect meal consumption in hospitalized patients with diabetes? ### Setting and sample Investigators recruited a convenience sample of patients from two medical and two surgical units in a large, urban, tertiary care facility in the Midwest. Adult patients diagnosed with type 1 or type 2 diabetes, > 20 years of age, who were receiving subcutaneous insulin were included. Patients receiving steroid therapy, oral glucose-lowering agents, tube feedings, parenteral nutrition, or pre-packaged kosher meals and those who could not understand English were excluded. The study took place from July to November 2007 with approval of the institutional review board. ### Study design Dietitians …