title: Glucose Variability Measures as Predictors of Oral Feeding Intolerance in Acute Pancreatitis: A Prospective Pilot Study.
abstract: Oral feeding intolerance (OFI) is a common complication in patients with acute pancreatitis (AP). Variations in blood glucose are associated with impaired gastrointestinal function but, to date, measures of glucose variability have not been investigated to predict OFI in patients with AP.
  
  
  
  To investigate the usefulness of several glucose variability measures in predicting the occurrence of OFI early in the course of AP.
  
  
  
  In this prospective cohort study, six measures of glucose variability were calculated prior to the occurrence of OFI. Multivariate binary logistic regression analyses were conducted, and the diagnostic performance and accuracy of glucose variability measures were assessed.
  
  
  
  Of the 95 prospectively enrolled patients, 21 (22%) developed OFI. After adjusting for confounders, admission blood glucose concentration and mean blood glucose concentration were significantly associated with OFI [odds ratio 1.49 (95% confidence interval 1.01-2.20) and odds ratio 1.67 (95% confidence interval 1.07-2.61), respectively]. Both admission blood glucose and mean blood glucose had an area under the curve of 0.83 and positive likelihood ratios of 6.45 and 10.19, respectively. Blood glucose concentration before refeeding, standard deviation of blood glucose concentration, coefficient of variation, and mean amplitude of glycemic excursions were not significantly associated with OFI.
  
  
  
  In-hospital blood glucose concentrations are associated with subsequent development of OFI in patients with AP. In particular, admission blood glucose and mean blood glucose could be useful predictors of OFI in this setting.
authors.affiliation: Department of Surgery, University of Auckland, Auckland, New Zealand.
authors.forename: Chirag J
authors.initials: CJ
authors.lastname: Jivanji
authors.affiliation: Department of Surgery, University of Auckland, Auckland, New Zealand.
authors.forename: Varsha M
authors.initials: VM
authors.lastname: Asrani
authors.affiliation: Department of Surgery, University of Auckland, Auckland, New Zealand.
authors.forename: Sayali A
authors.initials: SA
authors.lastname: Pendharkar
authors.affiliation: Department of Surgery, University of Auckland, Auckland, New Zealand.
authors.forename: Melody G
authors.initials: MG
authors.lastname: Bevan
authors.affiliation: Department of Surgery, University of Auckland, Auckland, New Zealand.
authors.forename: Nicola A
authors.initials: NA
authors.lastname: Gillies
authors.affiliation: Department of Surgery, University of Auckland, Auckland, New Zealand.
authors.forename: Danielle H E
authors.initials: DHE
authors.lastname: Soo
authors.affiliation: Department of Surgery, University of Auckland, Auckland, New Zealand.
authors.forename: Ruma G
authors.initials: RG
authors.lastname: Singh
authors.affiliation: Department of Surgery, University of Auckland, Auckland, New Zealand. max.petrov@gmail.com.
authors.forename: Maxim S
authors.initials: MS
authors.lastname: Petrov
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose; D004435:Eating; D001068:Feeding and Eating Disorders / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000150:complications*; D010865:Pilot Projects; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity
chemical_list: D001786:Blood Glucose
keywords: Acute pancreatitis; Blood glucose; Oral feeding intolerance; Prediction