Hyperglycemia In Parenteral Nutrition Therapy


  • Galuh Dwi Anjani Universitas Lampung
  • Mirza Junando Program Studi Farmasi, Fakultas Kedokteran Universitas Lampung
  • Rasmi Zakiah Oktarlina
  • Rani Himayani




diabetes mellitus, hy, insulin, parenteral nutrition


Hyperglycemia is a condition that often occurs in some patients on parenteral nutrition therapy, both with and without a diagnosis of diabetes mellitus. The incidence of hyperglycemia is closely related to an increase in length of stay and mortality in hospital. This literature review aims to provide an overview of the management of hyperglycemia related to parenteral nutrition therapy. The source search method was carried out using the Google Scholar, Pubmed and Elsevier search engines. The keywords used are management of hyperglycemia, risk factors, parenteral nutrition. Based on the results of the literature review, it was found that several factors trigger the incidence of hyperglycemia, including BMI > 25 kg/m2, advanced age, higher HbA1c, history of type 2 DM, use of glucocorticoid drugs and administration of excess carbohydrates and reduced insulin sensitivity. Several strategies to prevent hyperglycemia are carried out by providing low dextrose, hypocaloric parenteral nutrition, or combining parenteral and enteral nutrition. Providing combined nutrition can improve glycemic control in patients with sufficient endogenous insulin stores. Meanwhile, therapeutic measures need to be given if hyperglycemia persists after preventative strategies are implemented. Therapeutic measures that can be taken include administering insulin intravenously or subcutaneously to patients in stable condition. Alternatively, insulin can be added to the parenteral nutrition mixture. It is important to closely monitor blood glucose levels to reduce the risk of hyperglycemia or hypoglycemia.

Author Biographies

Mirza Junando, Program Studi Farmasi, Fakultas Kedokteran Universitas Lampung



Rasmi Zakiah Oktarlina



Rani Himayani




Thibault R, Heidegger CP, Berger MM, Pichard C. Parenteral nutrition in the intensive care unit: Cautious use improves outcome. he Eur J Med Sci. 2014;144(w13997):1-9. doi:10.4414/smw.2014.13997

Berger MM, Pichard C. When is parenteral nutrition indicated? J Intensive Med. 2022;2(1):22-28.

Schönenberger KA, Reber E, Dürig C, et al. Management of Hyperglycemia in Hospitalized Patients Receiving Parenteral Nutrition. Front Clin Diabetes Healthc. 2022;3(February):1-10.

Worthington P, Balint J, Bechtold M, et al. When is parenteral nutrition appropriate? J Parenter Enter Nutr. 2017;41(3):324-377.

Berlana D. Parenteral Nutrition Overview : Review. J Nutr. 2022;14(4480):1-24.

McMahon MM, Nystrom E, Braunschweig C, Miles J, Compher C. ASPEN clinical guidelines: Nutrition support of adult patients with hyperglycemia. J Parenter Enter Nutr. 2013;37(1):23-36.

Gosmanov AR, Umpierrez GE. Management of hyperglycemia during enteral and parenteral nutrition therapy. Curr Diab Rep. 2013;13(1):155-162.

Roszali MA, Zakaria AN, Mohd Tahir NA. Parenteral nutrition-associated hyperglycemia: Prevalence, predictors and management. Clin Nutr ESPEN. 2021;41:275-280.

Polavarapu P, Pachigolla S, Drincic A. Glycemic Management of Hospitalized Patients Receiving Nutrition Support. Diabetes Spectr. 2022;35(4):427-439.

Olveira G, Tapia MJ, Ocón J, et al. Parenteral nutrition-associated hyperglycemia in non-critically iII inpatients increases the risk of in- hospital mortality (multicenter study). Diabetes Care. 2013;36(5):1061-1066.

Martínez TG, Pauls BM, Cabrera AMV, Granell CL, Piqueres RF. Predictive factors of hyperglycemia in hospitalized adults receiving total parenteral nutrition. Farm Hosp. 2017;41(6):667-673.

Elizabeth PC, Rogelio Ramón PR, Félix Alberto MM. Hyperglycemia associated with parenteral nutrition in noncritical patients. Hum Nutr Metab. 2020;22(May):200114.

PERKENI. Tatalaksana Pasien Dengan Hiperglikemia Di Rumah Sakit. PB PERKENI; 2022.

Laesser CI, Cumming P, Reber E, Stanga Z, Muka T, Bally L. Management of glucose control in noncritically ill, hospitalized patients receiving parenteral and/or enteral nutrition: A systematic review. J Clin Med. 2019;8(7).

Drincic AT, Knezevich JT, Akkireddy P. Nutrition and Hyperglycemia Management in the Inpatient Setting (Meals on Demand, Parenteral, or Enteral Nutrition). Curr Diab Rep. 2017;17(8).

Lidder P, Flanagan D, Fleming S, et al. Combining enteral with parenteral nutrition to improve postoperative glucose control. Br J Nutr. 2010;103(11):1635-1641.

Singer P, Reintam A, Berger MM, et al. ESPEN Guideline ESPEN guideline on clinical nutrition in the intensive care unit. Clin Nutr. 2019;38:48-79.

Gomes F, Schuetz P, Bounoure L, et al. ESPEN guidelines on nutritional support for polymorbid internal medicine patients. Clin Nutr. 2018;37(1):336-353.

McClave SA, Taylor BE, Martindale RG, et al. Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.). J Parenter Enter Nutr. 2016;40(2):159-211.

Stehle P, Ellger B, Kojic D, et al. Glutamine dipeptide-supplemented parenteral nutrition improves the clinical outcomes of critically ill patients: A systematic evaluation of randomised controlled trials. Clin Nutr ESPEN. 2017;17:75-85.

Chawla R, Gangopadhyay K, Lathia T, et al. Management of hyperglycemia in critical care. J Diabetol. 2022;13(1):33.

ADA. Diabetes Care in the Hospital : Standards of Medical Care in Diabetes — 2022. In: Diabetes Care. Vol 45(Suppl.1. ; 2022:244-253.



How to Cite

Dwi Anjani, G., Junando, M., Oktarlina, R. Z. ., & Himayani, R. . (2024). Hyperglycemia In Parenteral Nutrition Therapy. Medical Profession Journal of Lampung, 14(4), 706-711. https://doi.org/10.53089/medula.v14i4.1050




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