{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T15:31:12Z","timestamp":1787758272229,"version":"build-2784847793"},"reference-count":9,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,5]]},"abstract":"Abstract<\/jats:title>\n \n Background:<\/jats:title>\n As malnutrition negatively impacts hospital outcomes, hospitalised patients should receive proper nutritional management. Enteral nutrition (EN) is the most common route for non-volitional dietary support, usually fed four times\/day. It is different from patients with volitional feeding who receive only three meals\/day. This practice may affect blood glucose (BG) control in enteral feeding diabetes patients and increase nursing care\u2019s working burden. As a result, the study aimed to compare BG control and enteral feeding complications between 3 and 4 times feeding\/day in hospitalised diabetes patients who require EN.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n A non-blind randomised controlled trial study was conducted in 37 types two diabetes hospitalised patients who required EN in Thammasat University hospital (TUH) from April 1 to December 31, 2019. The study patients were randomised and stratified by HbA1C at <8% or \u22658% to treat three meals or four meals\/day. BG was controlled based on the insulin injection protocol of TUH. The study data was collected at least five days until the patients were stopped EN or discharged from the hospital. The primary outcome was a percentage of times BG was in controlled at \u2264180mg\/dl. The secondary outcomes were any feeding complications such as frequency of hypoglycemia, diarrhea and gastric residual volume over 100 ml before the next feeding time.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n 37 patients were included. 83% of the patients were female, and the mean age was 78.44 \u00b1 8.14 and 74.11 \u00b1 10.03 years old in three meals and four meals feeding group, respectively. There were none significant in mean percentage of BG control between three times and four times\/day either in HbA1C <8% and HbA1C \u22658% (52.21% and 68.43%,\n P<\/jats:italic>\n value = 0.192 and 54.29% and 55.10%,\n P<\/jats:italic>\n value = 0.942, respectively). Percentage of hypoglycemic events were none significant in 3 vs 4 times feeding at 1.70% vs 0.99%,\n P<\/jats:italic>\n value = 0.552 and 2.53% vs 2.00%,\n P<\/jats:italic>\n value = 0.727 in HbA1C <8% and HbA1C \u22658%, respectively. However, other complications were not significant between two groups.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n There was no clinically significant outcome on BG control and other complications between three and four times feeding\/day in type 2 diabetes hospitalised patients. Therefore, three times feeding can be implied in clinical practice to reduce the burden of nursing care.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/ijem.ijem_79_22","type":"journal-article","created":{"date-parts":[[2022,8,3]],"date-time":"2022-08-03T05:29:27Z","timestamp":1659504567000},"page":"259-264","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["The Comparison of the Effects of three Meals Feeding a Day and Four Meals Feeding a Day in Type 2 Diabetes Mellitus Hospitalised Patients in Thammasat University Hospital on Blood Sugar Control and Enteral Feeding Complications"],"prefix":"10.4103","volume":"26","author":[{"given":"Kwansuphang","family":"Wongwatanasanti","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanit","family":"Wichansawakun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R3-11-20240828","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/BF02407387","article-title":"Indications for tube feedings in elderly patients","volume":"5","author":"Ciocon","year":"1990","journal-title":"Dysphagia"},{"key":"R4-11-20240828","doi-asserted-by":"crossref","first-page":"1552","DOI":"10.1007\/s00125-014-3253-5","article-title":"Eating two larger meals a day (breakfast and lunch) is more effective than six smaller meals in a reduced-energy regimen for patients with type 2 diabetes:A randomised crossover study","volume":"57","author":"Kahleova","year":"2014","journal-title":"Diabetologia"},{"key":"R8-11-20240828","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1210\/jc.2011-2098","article-title":"Management of hyperglycemia in hospitalized patients in non-critical care setting:An endocrine society clinical practice guideline","volume":"97","author":"Umpierrez","year":"2012","journal-title":"J Clin Endocrinol Metab"},{"key":"R9-11-20240828","first-page":"E7","article-title":"Inpatient glucose control:Aglycemic survey of 126 U.S. hospitals","volume":"4","author":"Cook","year":"2009","journal-title":"JHosp Med"},{"key":"R10-11-20240828","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1177\/0148607115621863","article-title":"Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient:Society of critical care medicine (SCCM) and American society for parenteral and enteral nutrition (A.S.P.E.N.)","volume":"40","author":"McClave","year":"2016","journal-title":"J Parenter Enteral Nutr"},{"key":"R11-11-20240828","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1038\/ajg.2016.28","article-title":"ACG clinical guideline:Nutrition therapy in the adult hospitalized patient","volume":"111","author":"McClave","year":"2016","journal-title":"Am J Gastroenterol"},{"key":"R12-11-20240828","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1371\/journal.pone.0038632","article-title":"Effects of meal frequency on metabolic profiles and substrate partitioning in lean healthy males","volume":"7","author":"Munsters","year":"2012","journal-title":"PLoS One"},{"key":"R13-11-20240828","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1093\/ajcn\/81.1.16","article-title":"Beneficial metabolic effects of regular meal frequency on dietary thermogenesis, insulin sensitivity, and fasting lipid profiles in healthy obese women","volume":"81","author":"Farshchi","year":"2005","journal-title":"Am J Clin Nutr"},{"key":"R14-11-20240828","doi-asserted-by":"crossref","first-page":"1484","DOI":"10.1017\/S0007114514002128","article-title":"Alteration of postprandial glucose and insulin concentrations with meal frequency and composition","volume":"112","author":"Kanaley","year":"2014","journal-title":"Br J Nutr"}],"container-title":["Indian Journal of Endocrinology and Metabolism"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/ijem.ijem_79_22","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T15:07:58Z","timestamp":1787756878000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/ijem.ijem_79_22"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5]]},"references-count":9,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2022]]}},"URL":"https:\/\/doi.org\/10.4103\/ijem.ijem_79_22","relation":{},"ISSN":["2230-9500"],"issn-type":[{"value":"2230-9500","type":"print"}],"subject":[],"published":{"date-parts":[[2022,5]]}}}