What is a potential risk associated with hyperglycemia during parenteral feeding?

Hyperglycemia during parenteral feeding can lead to hyperglycemic hyperosmolar nonketotic syndrome (HHNK), a serious complication characterized by extremely high blood glucose levels, often exceeding 600 mg/dL. In patients receiving parenteral nutrition, the infusion of carbohydrates can be considerable, which can result in elevated blood sugar levels if not properly managed.

HHNK is typically seen in patients with type 2 diabetes or those with insulin resistance, and it can lead to severe dehydration and electrolyte imbalances due to osmotic diuresis. The high glucose levels draw water out of cells and into the extracellular space, resulting in increased urination and fluid loss.

Recognizing hyperglycemia as a risk factor for HHNK is crucial for the management of patients on parenteral feeding, allowing healthcare providers to adjust insulin requirements and carbohydrate intake appropriately to mitigate this risk.