Outcome of glycemic control in critically ill patients receiving enteral formulas.

Abstract

Background and Objectives: Stress hyperglycemia is a common condition in critically ill patients. Inappropriate nutritional supplementation may worsen blood glucose control in these patients. The present study aimed to investigate the outcome of blood glucose control status when using various enteral formulas. Methods and Study Design: This retrospective study was conducted at the intensive care unit of a tertiary medical center in central Taiwan. Patients meeting the following inclusion criteria were enrolled in the study: age ≥20 years, respiratory failure requiring mechanical ventilation, and two consecutive blood glucose concentration measurements of ≥180 mg/dL. Demographic data, blood glucose samples, and hospital mortality were collected for analysis. Results: A total of 4,604 blood glucose samples from 48 patients were analyzed. Results demonstrated no significant difference in mortality rate or blood glucose control between patients fed semi-elemental formulas and those fed polymer formulas. Serum HbA1C of ＜7.5% was a risk factor for hospital mortality (OR: 0.18, 95% CI: 0.04-0.89). Enteral formulas containing less carbohydrate were associated with better blood glucose control. Conclusions: No significant difference in the outcome of blood glucose control was observed between patients fed semi-elemental formula and those fed polymer formula. To achieve better blood glucose control in critically ill patients, formulas with lower carbohydrate content should be considered.