Dietary management of blood glucose in medical critically ill patients with overweight/obesity

Research output: Contribution to journalReview articlepeer-review

4 Scopus citations

Abstract

Purpose of reviewAs the obesity epidemic continues, there is a greater proportion of patients with overweight, obesity, and other forms of adiposity-based chronic disease that require intensive care. Nutrition therapy in the ICU is a vital part of critical care but can be challenging in this setting because of the increased risk of stress hyperglycemia and adverse impact of obesity- and diabetes-related complications.Recent findingsCurrent guidelines favor early nutritional therapy with a hypocaloric, high-protein diet in patients with overweight/obesity. More aggressive protein intake may be useful in those with greater severity of overweight/obesity with an upper limit of 3 g/kg ideal body weight per day. Although there is no specific recommendation, choosing enteral formulas with higher fat content and slower digesting carbohydrates may assist with glucose control. Supplementation with immunonutrients is recommended, given their known benefits in obesity and in reducing inflammation, but must be done in an individualized manner.SummaryAggressive nutritional therapy is crucial in patients with overweight/obesity to support ongoing metabolic demands. Although a hypocaloric high-protein feeding strategy is a starting point, nutritional therapy should be approached in an individualized manner taking into account age, weight and BMI, basal metabolism, nutrition status, complications, and comorbidities.

Original languageEnglish
Pages (from-to)116-120
Number of pages5
JournalCurrent Opinion in Clinical Nutrition and Metabolic Care
Volume23
Issue number2
DOIs
StatePublished - 1 Mar 2020

Keywords

  • Adiposity-based chronic disease
  • Critical illness
  • Hypocaloric diet
  • Obesity
  • Overweight
  • Stress hyperglycemia

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