Invited Review Management of Blood Glucose and Diabetes in the Critically Ill Patient Receiving Enteral Feeding

ABSTRACT: Diabetes mellitus causes profound alter-ations in nutrient metabolism, leading to long-term sys-temic complications, particularly in individuals with poorly controlled disease. Nutrition support clinicians need to be aware of the effect of acute illness on stress-induced and established diabetes mellitus and the appro-priate management strategies. Because enteral feeding is a vital component of critical care for many patients with diabetes mellitus, it is important to develop techniques to best manage metabolic control during enteral feeding. This article will review mechanics of blood glucose regu-lation, evaluation of energy sources for patients with diabetes mellitus, selection of enteral formulas and infu-sion routes, and glycemic control in patients receiving tube feeding. At this point, it is appropriate to use