Diabetes and Parenteral Nutrition

Use of parenteral nutrition (PN) serves as an option for provision of macro- and micronutrients in patients with a nonfunctional gastrointestinal tract. Treatment with PN contributes to clinical improvement in appropriate patients; however, metabolic effects and complications may develop. Common complications include line infections, liver disease as both cholestasis and hepatosteatosis, hypertriglyceridemia, and hyperglycemia. The risk for each of these complications is increased in patients with either type 1 or type 2 diabetes mellitus. Risk reduction and treatment of complications may be attained through adjustment of the PN formula. Reduction of dextrose content, use of a fish oil-based lipid formulation, appropriate micronutrient supplementation, and coordinated administration of insulin can address the risks of PN administration, especially among patients with diabetes mellitus.