Nutritional risk screening in hospitalized and haemodialysis patients.

Malnutrition is an independent risk factor impacting on higher complications and increased length of hospital stay and costs. The aim of this study was to determine the prevalence of nutritional risk among patients on regular haemodialysis (HD) (Group I, N = 105) and among the patients at Gastroenterology, Endocrinology, Hematology and Clinical Immunology (Group II, N = 652). Cross-sectional nutritional evaluation was done using Nottingham Hospital Screening Tool (NS). The prevalence of nutritional risk was 9% in Group I and 21% in Group II (p = 0.0002). We found statistically significant larger quantity of malnourished patients among acute internistic patients than among chronic from the same Group II. Malnutrition among patients on HD didn't differ statistically to chronic internistic patients. We didn't found a significantly higher percentage of nutritional risk among elderly patients (65 years and more). Correlation between body mass index (BMI) and NS was significant, but weak (r = -0.32). We can conclude that the prevalence of nutritional risk among HD patients was lower than we had expected. It seems that the screening tool we used is not sensitive enough for HD patients and needs further investigations.

Assessing glycemia in type 1 diabetic patients using a microdialysis system for continuous glucose monitoring.

BACKGROUND: Continuous glucose monitoring systems can monitor moment-to-moment changes in blood glucose concentration, which cannot be detected by intermittent self-monitoring. Continuing monitoring systems may lead to improved glycemic control. We evaluated a microdialysis technique for improving glycemic control in type 1 diabetes patients treated by different means of basal insulin substitution. PATIENTS AND METHODS: Fifty-two type 1 diabetic patients on twice daily NPH and pre-meal aspart insulin were randomized in two groups: the continuation of NPH (n=26) (group 1) or once daily glargine (n=26) (group 2). 48-hour GlucoDay registrations were started at the beginning and after 4 months. RESULTS: At baseline, time spent in the euglycemic range (glucose between 3.9 and 8.0 mmol/L) was 37.96+/-6.81% for the NPH group and 35.83+/-6.24% for the glargine group. At endpoint, time in the euglycemic range increased in both groups (51.02+/-7.22% and 57.29+/-10.27%, P<0.001 vs. before treatment for both groups). Time spent in the hypoglycemic range (glucose <3.9 mmol/L) was 9.+/-2.57% for the first group and 10.24+/-3.55% for the second group at baseline. At endpoint, time in the hypoglycemic range decreased in both groups (8.00+/-2.13% and 6.59+/-2.04%, P<0.001 vs. before treatment for both groups). CONCLUSION: The analysis of the GlucoDay data gave us information about glycemia other than HbA1c and self-monitoring of blood glucose, such us a peakless activity profile and the lower percentage of time spent in the hypoglycemic range in the glargine-treated group.