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Journal of Pharmacy Practice
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Article

Enteral and Parenteral Nutrition for the Diabetic Patient: A Case-Based Approach

Andrea L. McKeever, PharmD, BCPS* and James W. Fetterman Jr, PharmD

* To whom correspondence should be addressed. E-mail: amckeever{at}southuniversity.edu.


   Abstract
Patients’ nutritional status is essential to ensure beneficial outcomes. However for the diabetic, the caloric energy required is not only sustaining but problematic if not managed appropriately. Uncontrolled hyperglycemia places these patients at risk of complications such as infections, neuropathy, and retinopathy. Health care providers can assist in tailoring nutritional support for diabetic patients. Possible interventions include adjusting caloric requirements to minimize carbohydrates and maximize fat as a main calorie substitute and to suggest appropriate macronutrient sources. Other disease state complications such as diabetic-associated nephropathy and gastroparesis affect nutritional support and present opportunity for further interventions. Diligence regarding blood glucose monitoring is imperative. Additional anti-diabetic therapies can be used to maintain tight glucose control; however, close monitoring must occur to minimize hypoglycemic episodes, which can be life-threatening.

First published on March 12, 2009
Journal of Pharmacy Practice 2009, doi:10.1177/0897190009333162


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