BACKGROUND: Enteral nutrition is nutrition provided through the gastrointestinal tract, which delivers nutrition distal to the oral cavity. Critically ill patients are at high nutrition risk thus the need for full nutrition assessment At present, NUTRIC score is one of the reliable assessment tools for quantifying risk of developing adverse outcome in critically ill patients, which may be modifiable by aggressive nutrition therapy. OBJECTIVES: We assessed the nutrition risk levels as measured by NUTRIC score among admitted patients who were given enteral nutrition at the Intensive Care Unit of Cebu Doctors' University Hospital from June 2016 to June 2017. METHODOLOGY: This is a one-year single-center cross-sectional retrospective chart review study on admitted ICU patients from June 2016 to June 2017. Categorical profiles were expressed in frequency and percentage while those continuous variables were described in mean and standard deviations. Moreover, incidence rate of nutrition risk levels of patients was computed. In comparing the required and actual feeding amount of patients was compared using the Paired t-test wherein a p-values lesser than 0.05 alpha were considered significant. IBMSPSS ver 21 was used as software. RESULTS: This study has shown that 86.4% of the patients admitted in this institution's ICU were started on early enteral feeding within 24 to 48 hours of ICU admission. From the subjects given EN, only 21 (5.8%) were able to achieve the energy requirement. In those subjects who did not achieve the required energy requirement, there is an associated increased length of stay in the ICU (p-value of 0.045). Based on NUTRIC score, out of 52 patients included in this study, 39 patients (75%) were identified to be at low risk while 13 subjects (25%) were at high risk for a 28-day mortality. CONCLUSION Early initiation of enteral nutrition was being practiced among patients admitted to ICU in our institution. However, majority of patients given enteral feeding were not given the required energy requirement. The ICU patients who were given early nutrition feeding were associated with decreased length of ICU stay.

BACKGROUND: The long term complications of diabetes lead to diminished quality of life. As a means to avoid these complicationss, insulin therapy had evolved into a specialized regimen to achieve physiologic control of blood glucose, the so-called Multiple Daily Insulin (MDI) regimen which is a relatively new technique in the Philippines.
OBJECTIVE: To study the efficacy of Multiple Daily Insulin regimen in controlling plasma glucose and to evaluate patient's satisfaction with MDI regimen among Filipino type 2 diabetics who have been on MDI for at least 2 months.
RESEARCH DESIGN AND METHODS: Filipino patients (n=107) with uncontrolled diabetes were included in the study protocol. The majority were male, more than 60 years old and had been diabetic for more than 6 years. The mean body mass index was 27 kg/m2 and the mean baseline HbA1c was 9.2% + 2.65. This prospective cohort study was conducted between January 2006 to September 2008 at Cebu Doctors University Hospital Out-Patient Department. Efficacy was evaluated by HbA1c and treatment satisfaction was assessed with the Diabetes Treatment Satisfaction Questionnaire (DTSQ). Enrolled patients were followed up at week 12, 24 and 48.                                                                                                      
RESULTS: Mean HbA1c fell by 2.43 + 2.68 at week 12, 2.03 + 2.35 at week 24 and 1.73 + 2.23 at week 48 showing a statistically significant decrease of HbA1c among the 3 groups was not statistically significant (p = 0.52). The proportion of patients achieving an HbA1c of < 7% at week 12, 24, and 48 were 42%, 52% and 42%, respectively. Treatment satisfaction improved significantly (p = 0.000) with MDI regimen using the DTSQ at the end of the study.        
CONCLUSION: Multiple Daily Insulin Regimen is an effective treatment modality based on a significant lowering of HbA1c among the study population with uncontrolled type 2 diabetes mellitus. Patients were satisfied with the ragimen based on the positive treatment satisfaction. This, however, is contrary to popular belief that patients' quality of life is affected by insulin administration. Keywords: Multiple Daily Insulin Injection, Type Diabetes Mellitus, Treatment Satisfaction.

Human ; Male ; Female ; Aged ; Middle Aged ; Adult ; Blood Glucose ; Diabetes Mellitus, Type 2 ; Insulin ; Insulin Infusion Systems ; Outpatients ; Philippines ; Physician-patient Relations ; Prospective Studies ; Quality Of Life ; Treatment Outcome

Hypoglycemia