Pitts D M, Kilo K A, Pontious S L
Crit Care Nurs Clin North Am. 1993 Mar;5(1):47-56.
Nutritional support for critically ill patients with diabetes mellitus will be successful when nutrition meets the patient's metabolic needs; blood glucose levels are maintained between 100 and 200 mg/dL; complications of hyperglycemia, sepsis, and hypoglycemia are prevented; insulin dosages take basal metabolic needs, stress level, pharmacologic therapy, and the degree of illness into account; and nutritional support is provided in the least invasive manner possible. Providing nutritional support without adequate glycemic control and appropriate insulin administration is counterproductive for the patient. Careful monitoring of blood glucose and blood chemistries, along with the physical assessment of patients receiving nutritional support, are essential to successful treatment. Further research is necessary to define better which levels of glycemic control are most beneficial for providing optimal nutritional support for critically ill patients with diabetes mellitus.
当营养满足患者的代谢需求、血糖水平维持在100至200毫克/分升之间、预防高血糖、败血症和低血糖并发症、胰岛素剂量考虑到基础代谢需求、应激水平、药物治疗和疾病程度，并且以尽可能微创的方式提供营养支持时，对重症糖尿病患者的营养支持将会成功。在没有充分的血糖控制和适当的胰岛素给药的情况下提供营养支持对患者会产生适得其反的效果。仔细监测血糖和血液化学指标，以及对接受营养支持的患者进行体格评估，对于成功治疗至关重要。有必要进行进一步研究，以更好地确定哪种血糖控制水平对为重症糖尿病患者提供最佳营养支持最为有益。
