Parenteral nutrition hypoglycemia

When discontinuing parenteral nutrition, it is important to taper over several days to prevent hypoglycemia... 

Caution Do not suddenly interrupt parenteral nutrition support therapy. The patient can experience hypoglycemia. Discontinue gradually by decreasing the infusion rate. Monitor for hypoglycemia. 

Clinical signs and symptoms of hypoglycemia are reported occasionally most cases are subclinical, but severe cases have been described (SEDA-13, 815). A study of the effect of quinidine on glucose homeostasis in Thai patients with malaria showed a near doubling of plasma insulin concentrations and a corresponding fall in serum glucose concentrations. An additional factor may have been impaired nutritional status and the effects of parenteral quinine in severely ill patients not taking food (SEDA-13, 815 SEDA-14, 240 SEDA-18, 288). 

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