REZA ANDRIANI, NIM: 051715153017 (2019) ANALISIS PEMBERIAN NUTRISI PARENTERAL TERHADAP KADAR GULA DARAH PASIEN GERIATRI (Penelitian dilakukan di IRNA Geriatri RSUP Sanglah Denpasar). Thesis thesis, UNIVERSITAS AIRLANGGA.

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Abstract

Background: The beneficial effect of parenteral nutrition (PN) in improving the nutritional status of malnourished patients have been well established. However, many trials have reported PN associated complications especially hyperglycemia. Geriatrics are at high risk for the development of hyperglycemia due to impaired β cell function, multiple diseases and stress conditions, leading to reduced insulin secretion and insulin resistance. Objective: This study aims to analyze the effect of parenteral nutrition on blood glucose levels and the prevalence of hyperglycemia in geriatric patients. Method: A prospective observational design was conducted in this study. The blood glucose measured before and daily while receiving parenteral nutrition. Data was collected at the period of January to March 2019. The inclusion criteria were geriatric patients (≥ 60 years) who received parenteral nutrition, were not diagnosed with diabetes mellitus and blood glucose levels before administration of PN <180 mg/dL. Results: This study included 38 patients with 43 parenteral nutrition prescription. Using paired t-test analysis, there were significant differences between blood glucose levels before and 6 hours after administration of PN(p<0,05). Based on the type of nutrition, the increase in blood glucose levels at 6 hours after administration of PN was higher in "3 in 1" 17.6 ± 42.1 mg/dL compared with "2 in 1" which was 12.1 ± 39,8 mg/dL, although not statistically significant (p>0,05). There were 14 (7,2%) cases of hyperglycemia (blood glucose levels> 180 mg / dl)from 193 blood glucose measurement. During PN therapy, 11 patients (29%) had at least one hyperglycemia event. Predisposising factor were glucose-elevating drugs (OR 15.95; 95%CI 1.20-211.09; p=0,036), enteral nutrition, infectious complication, and renal impairment. Conclusion: The prevalence oh hyperglycemia in geriatric patients receiving parenteral nutrition is quite high. It s recommended to monitor blood gluocose in geriatric patients who had risk factors of hyperglycemia with parenteral nutrition.

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