Background: Hyperglycemia is often a problem in patients who receive continuous enteral nutrition. The purpose of this Study was to determine if the use of sliding-scale neutral protamine Hagedorn (NPH) insulin was more effective than sliding-scale insulin aspart in controlling blood glucose in continuously tube-fed patients. Methods: A retrospective, records-based review comparing sliding-scale NPH insulin given every, 4 or 6 hours with sliding-scale insulin aspart was performed in patients admitted to 2 community hospitals between April 1, 2006, and September 30, 2007. Results: Mean blood glucose was found to be lower in patients receiving NPH every 4 hours and NPH every 6 hours than in patients receiving insulin aspart (P < .001). No statistically significant differences in mean blood glucose values (P = .41) were observed between patients receiving the NPH regimen given every 4 or 6 hours. More patients in the NPH groups had blood glucose values in the target and acceptable ranges than those in the insulin aspart group (P < .001), but no statistical significance was observed between the groups receiving NPH every 4 hours and NPH every 6 hours (P = .41). Conclusions: In this study sliding-scale NPH insulin was demonstrated to be a safe and effective management strategy for blood glucose control in continuously tube-fed patients; NPH insulin resulted in better blood glucose control compared with insulin aspart. (Nutr Clin Pract. 2009;24:718-722)
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W Virginia Univ, Dept Family Med, Sch Med, Eastern Div, Harpers Ferry, WV 25425 USAW Virginia Univ, Dept Family Med, Sch Med, Eastern Div, Harpers Ferry, WV 25425 USA
Nau, Konrad C.
Lorenzetti, Rosemarie C.
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W Virginia Univ, Dept Family Med, Sch Med, Eastern Div, Harpers Ferry, WV 25425 USAW Virginia Univ, Dept Family Med, Sch Med, Eastern Div, Harpers Ferry, WV 25425 USA
Lorenzetti, Rosemarie C.
Cucuzzella, Mark
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W Virginia Univ, Dept Family Med, Sch Med, Eastern Div, Harpers Ferry, WV 25425 USAW Virginia Univ, Dept Family Med, Sch Med, Eastern Div, Harpers Ferry, WV 25425 USA
Cucuzzella, Mark
Devine, Timothy
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W Virginia Univ, Dept Family Med, Sch Med, Eastern Div, Harpers Ferry, WV 25425 USAW Virginia Univ, Dept Family Med, Sch Med, Eastern Div, Harpers Ferry, WV 25425 USA
Devine, Timothy
Kline, Jonathan
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W Virginia Univ, Dept Family Med, Sch Med, Eastern Div, Harpers Ferry, WV 25425 USAW Virginia Univ, Dept Family Med, Sch Med, Eastern Div, Harpers Ferry, WV 25425 USA