St. Vincent Indianapolis Hospital, Indianapolis, Indiana, USA.
Nutr Clin Pract. 2009 Dec;24(6):718-22. doi: 10.1177/0884533609351531.
Hyperglycemia is often a problem in patients who receive continuous enteral nutrition. The purpose of this study was to determine if the use of sliding-scale neutral protamine Hagedorn (NPH) insulin was more effective than sliding-scale insulin aspart in controlling blood glucose in continuously tube-fed patients.
A retrospective, records-based review comparing sliding-scale NPH insulin given every 4 or 6 hours with sliding-scale insulin aspart was performed in patients admitted to 2 community hospitals between April 1, 2006, and September 30, 2007.
Mean blood glucose was found to be lower in patients receiving NPH every 4 hours and NPH every 6 hours than in patients receiving insulin aspart (P < .001). No statistically significant differences in mean blood glucose values (P = .41) were observed between patients receiving the NPH regimen given every 4 or 6 hours. More patients in the NPH groups had blood glucose values in the target and acceptable ranges than those in the insulin aspart group (P < .001), but no statistical significance was observed between the groups receiving NPH every 4 hours and NPH every 6 hours (P = .41).
In this study, sliding-scale NPH insulin was demonstrated to be a safe and effective management strategy for blood glucose control in continuously tube-fed patients; NPH insulin resulted in better blood glucose control compared with insulin aspart.
高血糖症在接受连续肠内营养的患者中很常见。本研究旨在确定使用中效胰岛素（NPH）与使用门冬胰岛素相比，是否更能有效控制持续管饲患者的血糖。
对 2006 年 4 月 1 日至 2007 年 9 月 30 日期间入住 2 家社区医院的患者进行了回顾性、基于记录的研究，比较了每 4 小时或 6 小时给予中效胰岛素 NPH 与门冬胰岛素的方案。
与接受门冬胰岛素的患者相比，每 4 小时和每 6 小时接受 NPH 的患者的平均血糖水平更低（P<0.001）。接受每 4 小时或 6 小时给予 NPH 方案的患者之间，平均血糖值无统计学差异（P=0.41）。与接受门冬胰岛素的患者相比，接受 NPH 治疗的患者血糖值在目标和可接受范围内的患者更多（P<0.001），但每 4 小时和每 6 小时接受 NPH 的患者之间无统计学差异（P=0.41）。
在这项研究中，中效胰岛素 NPH 被证明是一种安全有效的控制持续管饲患者血糖的管理策略；与门冬胰岛素相比，NPH 胰岛素可更好地控制血糖。
