Glycaemic control difficulties identified in people with diabetes on enteral feeding

A recent survey found that people with diabetes have generally poor glucose control during enteral feeding treatment.

The email-based survey was developed to assess the management of enteral feeding against the standards in the Joint British Diabetes Societies for Inpatient Care (JBDS) guidelines.

Academics who developed the survey sent it to 220 specialist diabetes teams throughout the UK gathered from Diabetes UK, the Association of British Diabetologists (ABCD), and the Diabetes Inpatient Specialist Nurse (DISN) UK Group databases.

The survey was completed by 26 hospitals. Guidelines for managing insulin with enteral feeding were in place at 11 of them. The survey results concluded that people with diabetes had difficulties sustaining glycaemic control whilst on enteral feeding treatment.

The researchers said: “There were three main feed regimens used: continuous 24-hour feeding, a single feed with one break in 24 hours, or multiple feeds in 24 hours.

“There were five regimens in common use: premixed insulin, isophane insulin, analogue basal insulin, variable rate intravenous insulin, or basal bolus insulin.

“Overall glucose control was poor for all regimens and combinations. Continuous feed showed better glucose control than a single feed with a break, mean (+SD) glucose 12.4 mmol/L (5.6) vs 15.1 mmol/L (6.9) p <0.005, but no group showed optimal control.”

The study can be read here.