Hyperglycemia During Home Parenteral Nutrition Administration in Patients Without Diabetes

Varayil, Jithinraj Edakkanambeth; Yadav, Subhash Kumar; Miles, John M.; Okano, Akiko; Kelly, Darlene G.; Hurt, Ryan T.; Mundi, Manpreet S.

doi:10.1177/0148607115606116

Cited by 16 publications

(7 citation statements)

References 39 publications

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“…Hyperglycemia is the most common complication of PN, especially at the beginning of therapy when patients are often acutely ill and malnournished 41 , 42 . The production of cytokines and counterregulatory hormones (eg, cortisol, epinephrine, glucagon, growth hormone) is upregulated during periods of stress or inflammation.…”

Section: Short‐term Metabolic Complicationsmentioning

confidence: 99%

“…Although hyperglycemia is commonly seen in patients receiving HPN, it does not appear to increase the risk of developing diabetes, and the impact on long‐term outcomes is unknown. Edakkanambeth Varayil et al 41 found that nearly 42% of their HPN patients developed hyperglycemia that required insulin. Incidence of hyperglycemia did not affect long‐term outcomes 41 .…”

Section: Short‐term Metabolic Complicationsmentioning

confidence: 99%

“…Edakkanambeth Varayil et al 41 found that nearly 42% of their HPN patients developed hyperglycemia that required insulin. Incidence of hyperglycemia did not affect long‐term outcomes 41 . Williams et al 49 studied the effects of HPN on long‐term hyperglycemia by measuring hemoglobin A1c (HbA1c) levels in 36 adult HPN patients.…”

Section: Short‐term Metabolic Complicationsmentioning

confidence: 99%

“…Patients receiving excessive dextrose calories in HPN, corticosteroids, sympathomimetics, immunosuppressants, and peritoneal dialysis with a high‐dextrose dialysate are also at an increased risk 43 , 50 . Increased age has also been found to be an independent risk factor for hyperglycemia 41 . Chromium deficiency causes hyperglycemia in rare occasions and is nonresponsive to insulin therapy 42 .…”

Section: Short‐term Metabolic Complicationsmentioning

confidence: 99%

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Metabolic Complications of Home Parenteral Nutrition

Davila

Konrad

2017

Nut in Clin Prac

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Home parenteral nutrition (HPN) has benefited countless patients since its initiation almost 5 decades ago. Over time, HPN has been found to be associated with various complications, including metabolic disorders. Metabolic complications can be grouped into short-term (eg, fluid imbalance, electrolyte disturbances, glucose abnormalities) and long-term (eg, hepatobiliary disorders, metabolic bone disease, iron deficiency anemia, manganese toxicity) categories. There are a number of treatment options for each complication. It is important to evaluate the entire clinical picture prior to initiating an intervention and use evidence-based interventions when available. A dedicated multidisciplinary team is best suited to prevent and manage complications when they are identified.

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Section: Short‐term Metabolic Complicationsmentioning

confidence: 99%

Section: Short‐term Metabolic Complicationsmentioning

confidence: 99%

Section: Short‐term Metabolic Complicationsmentioning

confidence: 99%

Section: Short‐term Metabolic Complicationsmentioning

confidence: 99%

See 2 more Smart Citations

Metabolic Complications of Home Parenteral Nutrition

Davila

Konrad

2017

Nut in Clin Prac

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“…While lifesaving for many, HPEN does have risk of life‐threatening complications 7 , 8 , 52 – 59 . Advances in nutrition care options have helped decrease risk of bloodstream infection, but patients can still experience bloodstream or skin and soft tissue infection with either enteral or parenteral access 53 , 56 , 60 .…”

Section: Benefits Of the Guidelinesmentioning

confidence: 99%

Parenteral and Enteral Nutrition—From Hospital to Home: Will It Be Covered?

et al. 2017

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With scientific advances allowing for the safe delivery of parenteral and enteral nutrition in the home setting, challenges have risen with determining how this will be financially feasible for patients. In the United States, the government is one of the major payers for home parenteral and enteral nutrition (HPEN). Thus, it is important for nutrition providers to have an understanding of the Medicare criteria that must be met in order for these services to be covered. It can be difficult for clinicians to sift through these requirements and decipher for whom and when HPEN is covered. As our nutrition science knowledge and delivery continue to grow and evolve, potential barriers to this coverage may arise. This article provides background on those currently on HPEN in the United States, the current Medicare HPEN coverage criteria, and challenges we may face in the future.

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Management of long‐term home parenteral nutrition: Historical perspective, common complications, and patient education and training

Mundi

Elfadil

Hurt

et al. 2022

J Parenter Enteral Nutr

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Intestinal failure (IF) is a rare disease that requires ongoing intravenous supplementation to sustain growth and health. Advancements in parenteral nutrition (PN) and central venous access in the 1960s and 1970s transformed a life-limiting disease to a chronic one in which patients are able to administer hydration, electrolytes, micronutrients, and macronutrients in the comfort of their home. However, despite ongoing advancements in the field of home PN (HPN), complications-whether related to central venous catheters or PN itself-remain common and can be associated with significant morbidity and mortality. Central venous access can be associated with thrombosis, central line-associated bloodstream infection, or damage and can result in loss of access over time. PN can be associated with IF-associated liver disease or hyperglycemia. The key to preserving central venous access and quality of life and maintaining health for patients with chronic IF (CIF) is education focused on prevention and prompt management of CIF complications as they arise. This education typically takes place at the time of initiation of HPN, either in the hospital setting or in the patient's home. The present manuscript describes the historical progression of HPN, prevalence and characteristics of CIF, and an in-depth discussion of the most common catheter-related and PN-related complications and their management, along with a discussion of our education and training process.

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Hyperglycemia During Home Parenteral Nutrition Administration in Patients Without Diabetes

Cited by 16 publications

References 39 publications

Metabolic Complications of Home Parenteral Nutrition

Metabolic Complications of Home Parenteral Nutrition

Parenteral and Enteral Nutrition—From Hospital to Home: Will It Be Covered?

Management of long‐term home parenteral nutrition: Historical perspective, common complications, and patient education and training

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