{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T00:40:09Z","timestamp":1760920809199,"version":"build-2065373602"},"reference-count":15,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,6,23]],"date-time":"2025-06-23T00:00:00Z","timestamp":1750636800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aspenjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Parenter Enteral Nutr"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Hyperglycemia following an acute ischemic stroke has been linked to increased morbidity and mortality. Because of changes in a hospital\u2010wide sliding\u2010scale insulin protocol to incorporate half\u2010doses at midnight due to hypoglycemia risk, we aimed to evaluate the safety and efficacy of half\u2010dose sliding\u2010scale insulin at midnight compared with full doses in patients with acute ischemic stroke receiving enteral nutrition.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This single\u2010center, retrospective cohort study involved 151 patients with acute ischemic stroke and receiving enteral nutrition in a neurocritical care unit between January 1, 2014, and December 31, 2021. The exposure of interest was half\u2010dose sliding\u2010scale insulin at midnight compared with full\u2010dose sliding\u2010scale insulin at midnight. The primary outcome was the incidence of hyperglycemia for a 48\u2010h period after stability while receiving enteral nutrition. Secondary outcomes were new infections, incidence of hypoglycemia, and incidence of delirium.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In the full\u2010dose group, 52 patients experienced hyperglycemia compared with 60 patients in the half\u2010dose group; however, after propensity matching for carbohydrate content in enteral nutrition and hemoglobin A1c, the results are not noninferior (risk difference, 3.9%; 95% CI, \u221221.2% to 13.3%; <jats:italic>P<\/jats:italic>\u2009=\u20090.1041). Delirium was significantly higher in the full\u2010dose group, whereas the half\u2010dose group had a higher rate of suspected bacterial infections.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The study indicates that administering half\u2010dose sliding\u2010scale insulin at midnight in patients with acute ischemic stroke receiving enteral nutrition is not noninferior to full doses in controlling hyperglycemia. However, differences in delirium and infection rates suggest that glycemic changes may influence other outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jpen.2787","type":"journal-article","created":{"date-parts":[[2025,6,23]],"date-time":"2025-06-23T04:16:07Z","timestamp":1750652167000},"page":"752-757","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association between insulin dose and hyperglycemia in hospitalized adults with ischemic stroke receiving continuous enteral nutrition: A retrospective cohort study"],"prefix":"10.1002","volume":"49","author":[{"given":"Heather M.","family":"Wallhauser","sequence":"first","affiliation":[{"name":"The University of Tennessee Medical Center Knoxville Tennessee USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7570-7380","authenticated-orcid":false,"given":"Leslie A.","family":"Hamilton","sequence":"additional","affiliation":[{"name":"The University of Tennessee Medical Center Knoxville Tennessee USA"},{"name":"The University of Tennessee Health Science Center College of Pharmacy Knoxville Tennessee USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6865-126X","authenticated-orcid":false,"given":"Skyler R.","family":"Brown","sequence":"additional","affiliation":[{"name":"The University of Tennessee Medical Center Knoxville Tennessee USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas J.","family":"Christianson","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology University of Tennessee Medical Center Knoxville Tennessee USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian F.","family":"Wiseman","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Tennessee Medical Center Knoxville Tennessee USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olivia N.","family":"Bray","sequence":"additional","affiliation":[{"name":"The University of Tennessee Health Science Center College of Pharmacy Knoxville Tennessee USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hayden W.","family":"Caldwell","sequence":"additional","affiliation":[{"name":"The University of Tennessee Health Science Center College of Pharmacy Knoxville Tennessee USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A. Shaun","family":"Rowe","sequence":"additional","affiliation":[{"name":"The University of Tennessee Medical Center Knoxville Tennessee USA"},{"name":"The University of Tennessee Health Science Center College of Pharmacy Knoxville Tennessee USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,6,23]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/0022-510X(76)90176-3"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000195175.29487.30"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.58.8.1209"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdi.12932"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1161\/hs1001.096194"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13098-022-00896-9"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.124.049178"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.59.5.669"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1159\/000047756"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2019.103208"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.2147\/DMSO.S369457"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000000669"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1051\/ject\/200638168"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000121747.71054.79"}],"container-title":["Journal of Parenteral and Enteral Nutrition"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aspenjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jpen.2787","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,19]],"date-time":"2025-10-19T13:05:57Z","timestamp":1760879157000},"score":1,"resource":{"primary":{"URL":"https:\/\/aspenjournals.onlinelibrary.wiley.com\/doi\/10.1002\/jpen.2787"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,23]]},"references-count":15,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,8]]}},"alternative-id":["10.1002\/jpen.2787"],"URL":"https:\/\/doi.org\/10.1002\/jpen.2787","archive":["Portico"],"relation":{},"ISSN":["0148-6071","1941-2444"],"issn-type":[{"type":"print","value":"0148-6071"},{"type":"electronic","value":"1941-2444"}],"subject":[],"published":{"date-parts":[[2025,6,23]]},"assertion":[{"value":"2024-05-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-24","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-23","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}