05). Increased total hypoglycaemia was associated with increased duration of nasogastric feeding (p=0.016). Hypoglycaemia was prevalent before the next medication dose find more and rare between medication administration and feed bolus: 34.8% and 4.3% of hypoglycaemic patients respectively. It was not possible to assess the impact of withheld feeds from available documentation. Frequencies of hypoglycaemia, severe hypoglycaemia and extended hypoglycaemia are shown in Table

3. Sulphonylurea treatment (SU) was associated with increased incidence of hypoglycaemia (p<0.001) and extended hypoglycaemia (p=0.038). All hypoglycaemic patients had increased BGM post-hypoglycaemia (6.1±1.6/day) and based on this 78% had medication decreased

in response to hypoglycaemia. Survival analysis showed a significantly longer time to a subsequent hypoglycaemic episode between patients whose treatment was reduced in response to hypoglycaemia and those whose treatment remained unchanged (p=0.008) (see Figure 1). There was no association with subsequent hyperglycaemia (p=0.33). Hypoglycaemic episodes were not uncommon in these patients. Comparison with other nasogastric studies is difficult due to lack of quantification of hypoglycaemic events.15 Rates of hypoglycaemia in this study (PPD 10.9%; PTG 3.5%) were higher than the two comparable studies (PPD – not reported8 and 1.1–1.3%9; PTG – 1.4–5.48 and 1.1–1.39), especially as both defined hypoglycaemia as <3.9mmol/L; the higher cut-off point would be expected to identify more hypoglycaemic episodes.16 Frequency of BGM selleck kinase inhibitor also varied from 6.1±1.6/day (this study) compared to 4/day,8 and 4/day+ (maximum 6/day).9 However,

it has been shown that increased BGM can increase documented inpatient hypoglycaemia and severe hypoglycaemia.17 Additionally, one study9 included subjects on dual oral and enteral feeding which may tend to decrease frequency of hypoglycaemia.6,18 Severe and extended hypoglycaemia are not quantified in the literature on nasogastric feeding but the high frequency of BGM in our study may have increased documentation of these.17 Hypoglycaemia and extended hypoglycaemia were statistically associated with SU, consistent with other reports www.selleck.co.jp/products/erlotinib.html documenting increased frequency of hypoglycaemia in SU treated individuals, especially those >65 years of age.19,20 As this was a retrospective observational study, duration of nasogastric feeding varied. We therefore used Kaplan-Meier survival curves for time to event analysis of the effect of reduction in medication post-hypoglycaemia on a subsequent hypoglycaemic episode. This meant that censored data which arose from cessation of nasogastric feeding before a subsequent hypoglycaemic event was observed, were taken into account. As a consequence, we have shown a significantly increased time to a subsequent hypoglycaemic event in those whose medication was reduced.