title: Glycemic Variation in Tumor Patients with Total Parenteral Nutrition.
abstract: BACKGROUND
  Hyperglycemia is associated with poor clinical outcomes and mortality in several patients. However, studies evaluating hyperglycemia variation in tumor patients receiving total parenteral nutrition (TPN) are scarce. The aim of this study was to assess the relationship between glycemia and tumor kinds with TPN by monitoring glycemic variation in tumor patients.
  
  
  METHODS
  This retrospective clinical trial selected 312 patients with various cancer types, whose unique nutrition treatment was TPN during the monitoring period. All patients had blood glucose (BG) values assessed at least six times daily during the TPN infusion. The glycemic variation before and after TPN was set as the indicator to evaluate the factors influencing BG.
  
  
  RESULTS
  The clinical trial lasted 7.5 ± 3.0 days adjusted for age, gender, family cancer history and blood types. There were six cancer types: Hepatic carcinoma (HC, 21.8%), rectal carcinoma (17.3%), colon carcinoma (CC, 14.7%), gastric carcinoma (29.8%), pancreatic carcinoma (11.5%), and duodenal carcinoma (DC, 4.8%). The patients were divided into diabetes and nondiabetes groups. No statistical differences in TPN glucose content between diabetes and nondiabetes groups were found; however, the tumor types affected by BG values were obvious. With increasing BG values, DC, HC and CC were more represented than other tumor types in this sequence in diabetic individuals, as well as in the nondiabetic group. BG was inclined to be more easily influenced in the nondiabetes group. Other factors did not impact BG values, including gender, body mass index, and TPN infusion duration time.
  
  
  CONCLUSIONS
  When tumor patients are treated with TPN, BG levels should be monitored according to different types of tumors, besides differentiating diabetes or nondiabetes patients. Special BG control is needed for DC, HC and CC in both diabetic and nondiabetic patients. If BG overtly increases, positive measurements are needed to control BG values. The ClinicalTrials.gov ID is NCT02024321.
authors.forename: Jin-Cheng
authors.initials: JC
authors.lastname: Yang
authors.forename: Yuan-Yuan
authors.initials: YY
authors.lastname: Dai
authors.forename: Li-Ming
authors.initials: LM
authors.lastname: Wang
authors.forename: Yi-Bin
authors.initials: YB
authors.lastname: Xie
authors.forename: Hai-Yan
authors.initials: HY
authors.lastname: Zhou
authors.affiliation: Department of Pharmacy, Cancer Hospital/Institute, Chinese Academy of Medical Sciences, Beijing 100021, China.
authors.forename: Guo-Hui
authors.initials: GH
authors.lastname: Li
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000032:analysis*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000097:blood; D010289:Parenteral Nutrition, Total / Q000379:methods*
chemical_list: D001786:Blood Glucose