Hyperglycemia management in patients receiving parenteral nutrition: A retrospective review of glycemic control management

Authors

Grace Feigl, Advocate Health - MidwestFollow
Beata Slomiany Mears, Advocate Health - MidwestFollow

Recommended Citation

Feigl G. Hyperglycemia management in patients receiving parenteral nutrition: A retrospective review of glycemic control management. Presented at: Illinois Pharmacy Resident Conference; May 16, 2025; Schaumburg, IL.

Affiliations

Advocate Good Samaritan Hospital

Presentation Notes

Presented at: Illinois Pharmacy Resident Conference; May 16, 2025; Schaumburg, IL.

Abstract

Purpose: Hospitalized patients receiving parenteral nutrition (PN) often require insulin to manage hyperglycemia. Glycemic control is crucial for improving patient outcomes, and insulin, administered either subcutaneously or within the PN, is the mainstay of treatment for hyperglycemia. No established standard of care exists for the preferred route of insulin administration in patients receiving PN.

Methods: A multicenter, retrospective review of patients receiving PN was conducted between August 31, 2023, and August 31, 2024, to compare the effects of two insulin regimens on glycemic control. This review included adults aged ≥ 18 years on continuous PN and had received insulin therapy, either subcutaneously or within the PN formulation. The primary outcome - glycemic control - was assessed by the percentage of glucose levels within the target range (70 to 180 mg/dL).

Results: A total of 66 patients were included in the review. Seventeen patients (51.5%) in the subcutaneous insulin group had greater than 70% of glucose levels within the target range compared to 12 patients (36.4%) in the insulin-within-PN group. Seventeen patients (51.5%) in the subcutaneous group experienced more than 25% of glucose levels in the hyperglycemic range compared to 22 patients (66.7%) in the insulin-within-PN group. The incidence of hypoglycemia was similar between groups, with four patients in the subcutaneous insulin group and five patients in the insulin within the PN group.

Conclusion: These results suggest glycemic control was comparable between groups, with a non-significant trend favoring the subcutaneous insulin group.

Document Type

Oral/Podium Presentation