{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:30:07Z","timestamp":1790728207004,"version":"4.1.0"},"reference-count":64,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T00:00:00Z","timestamp":1783382400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Hyperglycemia is a common complication in critically ill patients receiving enteral nutrition (EN). This review synthesizes evidence on its mechanisms, epidemiology, clinical implications, and nursing management to support precision glycemic care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic literature search identified 45 eligible studies, including randomized trials, retrospective studies, reviews, guidelines, and expert consensus statements. Given the lack of a universally accepted definition, enteral nutrition-related hyperglycemia was pragmatically defined as blood glucose \u22657.8 mmol\/L occurring within 24\u221272 h after initiation of enteral nutrition.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Reported incidence varies widely, from approximately 30\u221247% in general ICU populations to 60\u221280% following cardiac surgery, reflecting differences in definitions, patient characteristics, timing, and nutritional protocols. Based on thematic integration of existing evidence, we propose a six-level conceptual cascade framework, linking metabolic vulnerability, stress-hormone activation, exogenous substrate load, enteroinsular axis dysfunction, inflammation-mediated insulin resistance, and microbiota dysbiosis. Corresponding nursing strategies include diabetes-specific formulas, optimized feeding regimens, continuous glucose monitoring, and individualized insulin protocols within multidisciplinary care. These strategies may improve glycemic control; however, evidence for clinical outcome benefits remains limited and heterogeneous.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Further prospective studies are needed to validate the model and refine precision nursing strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnut.2026.1803501","type":"journal-article","created":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T05:47:20Z","timestamp":1783403240000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Enteral nutrition\u2013related hyperglycemia in critical illness: cascade conceptual model and implications for precision nursing\u2014a systematic review"],"prefix":"10.3389","volume":"13","author":[{"given":"Jiani","family":"Qian","sequence":"first","affiliation":[{"name":"School of Nursing, Shandong Second Medical University","place":["Weifang, China"]},{"name":"Department of Nursing, Affiliated Hospital of Shandong Second Medical University","place":["Weifang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quanquan","family":"He","sequence":"additional","affiliation":[{"name":"School of Nursing, Shandong Second Medical University","place":["Weifang, China"]},{"name":"Department of Nursing, Affiliated Hospital of Shandong Second Medical University","place":["Weifang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maoyun","family":"Miao","sequence":"additional","affiliation":[{"name":"School of Nursing, Shandong Second Medical University","place":["Weifang, China"]},{"name":"Department of Nursing, Affiliated Hospital of Shandong Second Medical University","place":["Weifang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weiwei","family":"Ni","sequence":"additional","affiliation":[{"name":"Weifang Key Laboratory for Clinical Nursing Research, Department of Nursing, Affiliated Hospital of Shandong Second Medical University","place":["Weifang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yulei","family":"Ma","sequence":"additional","affiliation":[{"name":"Weifang Key Laboratory for Clinical Nursing Research, Department of Nursing, Affiliated Hospital of Shandong Second Medical University","place":["Weifang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,7]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1016\/j.clnu.2018.08.037","article-title":"Espen guideline on clinical nutrition in the intensive care unit","volume":"38","author":"Singer","year":"2019","journal-title":"Clin 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