{"title":"Continuous glucose monitoring in adults with short bowel syndrome receiving overnight infusions of home parenteral nutrition.","authors":"Priyasahi Saravana, Meghan Lau, Hassan S Dashti","doi":"10.1038/s41430-024-01548-z","DOIUrl":null,"url":null,"abstract":"<p><strong>Background/objectives: </strong>Consumers of home parenteral nutrition (HPN) are susceptible to dysglycemia. The aim was to characterize 24-h glucose profiles of HPN consumers using continuous glucose monitors (CGM) and to identify factors that influence glucose.</p><p><strong>Subjects/methods: </strong>Glucose profiles of 20 adults with short bowel syndrome (SBS) without diabetes were assessed using the Freestyle Libre Pro CGM. Measures included mean 24-h glucose, coefficient of variation (%), % time in range (TIR 70-140 mg/dL), among others. HPN parameters and lifestyle behaviors were obtained from self-reports and validated surveys. Linear mixed-effects models were used to test associations with glycemic measures adjusted for age, sex, and BMI. Significance was considered at P < 0.05.</p><p><strong>Results: </strong>Participants (77% female, age = 52 years, BMI = 21.4 kg/m², 95% white) had a 24-h mean and CV for glucose of 94.69 (8.96) mg/dL and 20.27%, respectively, and a mean TIR of 87.73%. Among non-daily HPN-dependent patients, the mean glucose and TIR were higher on days receiving HPN. Tapering HPN was associated with -6.882 (95% confidence interval = -12.436, -1.329) % lower CV, and higher HPN dextrose content per gram was associated with 0.039 (95% confidence interval = 0.008, 0.07) % higher CV. Smoking, more depressive symptoms, and higher insomnia severity showed associations with glucose levels and variability.</p><p><strong>Conclusions: </strong>Metabolically stable HPN adult consumers have 24-h glucose measures comparable to healthy adults yet are notable for more time spent below range. The glucose profiles are influenced by HPN parameters such as tapering and dextrose and behaviors including smoking, depressive symptoms, and insomnia.</p>","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":" ","pages":""},"PeriodicalIF":3.6000,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Clinical Nutrition","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1038/s41430-024-01548-z","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"NUTRITION & DIETETICS","Score":null,"Total":0}
引用次数: 0
Abstract
Background/objectives: Consumers of home parenteral nutrition (HPN) are susceptible to dysglycemia. The aim was to characterize 24-h glucose profiles of HPN consumers using continuous glucose monitors (CGM) and to identify factors that influence glucose.
Subjects/methods: Glucose profiles of 20 adults with short bowel syndrome (SBS) without diabetes were assessed using the Freestyle Libre Pro CGM. Measures included mean 24-h glucose, coefficient of variation (%), % time in range (TIR 70-140 mg/dL), among others. HPN parameters and lifestyle behaviors were obtained from self-reports and validated surveys. Linear mixed-effects models were used to test associations with glycemic measures adjusted for age, sex, and BMI. Significance was considered at P < 0.05.
Results: Participants (77% female, age = 52 years, BMI = 21.4 kg/m², 95% white) had a 24-h mean and CV for glucose of 94.69 (8.96) mg/dL and 20.27%, respectively, and a mean TIR of 87.73%. Among non-daily HPN-dependent patients, the mean glucose and TIR were higher on days receiving HPN. Tapering HPN was associated with -6.882 (95% confidence interval = -12.436, -1.329) % lower CV, and higher HPN dextrose content per gram was associated with 0.039 (95% confidence interval = 0.008, 0.07) % higher CV. Smoking, more depressive symptoms, and higher insomnia severity showed associations with glucose levels and variability.
Conclusions: Metabolically stable HPN adult consumers have 24-h glucose measures comparable to healthy adults yet are notable for more time spent below range. The glucose profiles are influenced by HPN parameters such as tapering and dextrose and behaviors including smoking, depressive symptoms, and insomnia.
期刊介绍:
The European Journal of Clinical Nutrition (EJCN) is an international, peer-reviewed journal covering all aspects of human and clinical nutrition. The journal welcomes original research, reviews, case reports and brief communications based on clinical, metabolic and epidemiological studies that describe methodologies, mechanisms, associations and benefits of nutritional interventions for clinical disease and health promotion.
Topics of interest include but are not limited to:
Nutrition and Health (including climate and ecological aspects)
Metabolism & Metabolomics
Genomics and personalized strategies in nutrition
Nutrition during the early life cycle
Health issues and nutrition in the elderly
Phenotyping in clinical nutrition
Nutrition in acute and chronic diseases
The double burden of ''malnutrition'': Under-nutrition and Obesity
Prevention of Non Communicable Diseases (NCD)