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All Journal World Nutrition Journal Majalah Anestesia & Critical Care (MACC)
Nurul Ratna Mutu Manikam
Faculty of Medicine, University of Indonesia, Jakarta
Medicine & Pharmacology Public Health

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Olive Oil and Vegetable Extract in Modified Hospital Enteral Formula Improves Glycemic Variability in Critically-Ill Diabetic Ketoacidosis Obese Patient: A Case Report Anindhita, Bintari; Singal, Anna Maurina; Wardhani, Wahyu Ika; Manikam, Nurul Ratna Mutu; Aditianingsih, Dita
Majalah Anestesia & Critical Care Vol 42 No 1 (2024): Februari
Publisher : Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif (PERDATIN) / The Indonesian Society of Anesthesiology and Intensive Care (INSAIC)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55497/majanestcricar.v42i1.315

Abstract

Background: Severe hyperglycemia in diabetic ketoacidosis may elevate pro inflammatory cytokines, oxidative stress, and metabolic disruptions, impacting the nutritional status of critically ill patients. Diabetes-specific formula (DSF) administration is linked to favorable glycemic control, but research on the role of modified hospital enteral formulas in diabetic critical illness is lacking. Case Description: An obese 29-year-old male at risk of malnutrition, presented to the emergency room with decreased level of consciousness due to metabolic encephalopathy, diabetic ketoacidosis due to suspected type 1 diabetes mellitus, hypertension, and acute kidney injury. Medical nutritional therapy was provided via enteral route according to recent ESPEN, ASPEN and ADA recommendation. The administered enteral formula was a modified hospital-based enteral formula, consisting of a special kidney hospital-based enteral formula mixed with olive oil as source of monounsaturated fatty acid (MUFA) and vegetables as source of fibers. During the first week of hospitalization, the patient’s coefficient of variation (%CoV) of glycemic variability ranged between 17–61%, in addition, at the beginning of the second week of treatment there was also an increase in glycemic variability to 53%. This could be influenced by several factors. However, improvement in glycemic variability was observed in the following days. This improvement was in line with the gradual increase in MUFA and fiber intake, which reached its highest intake during the second week of hospitalization. Conclusion: Hospital-based enteral formula modified with olive oil and vegetable extract can be made to resemble the nutrients composition of diabetes specific formula and has a favorable effect on glycemic variability.
Validity test of the Global Leadership Initiative on Malnutrition (GLIM) diagnostic criteria compared with the American Society for Parenteral and Enteral Nutrition (ASPEN) criteria in inpatients at Dr. Cipto Mangunkusumo hospital: A cross-sectional study Oentiono, Oki Yonatan; Manikam, Nurul Ratna Mutu
World Nutrition Journal Vol. 8 No. i1 (2024): Volume 08 Issue 1, August 2024
Publisher : Indonesian Nutrition Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25220/WNJ.V08.i1.0008

Abstract

Background: Malnutrition experienced by numerous inpatients is linked to various complications. The Global Leadership Initiative on Malnutrition (GLIM), which established the latest malnutrition criteria, recommends a two-step methodology for diagnosing malnutrition in adult inpatients. This study aims to evaluate the validity of the GLIM criteria for the diagnosis of malnutrition in hospitalized patients at Cipto Mangunkusomo Hospital Jakarta by comparing them with the ASPEN criteria. Methods: This cross-sectional study was conducted at Cipto Mangunkusomo Hospital, Jakarta. Secondary data was taken from 100 inpatients from October 2021 to February 2022 selected by consecutive sampling technique. The diagnosis of malnutrition in the patients applied the ASPEN and GLIM criteria. Furthermore, data were analyzed using Cohen's Kappa and chi-square tests. Results: Of 100 inpatients, 63% were diagnosed with malnutrition according to the GLIM diagnostic criteria. Meanwhile, 48% of them were found to be malnourished according to the ASPEN criteria. The GLIM criteria have a specificity of 69.2%, a sensitivity of 97.9%, a PPV of 74.6%, and an NPV of 97.3%. Conclusion: The GLIM diagnostic criteria are valid as an instrument for diagnosing malnutrition but require further research to assess the severity of malnutrition.
Co-Authors Anindhita, Bintari Dita Aditianingsih Oentiono, Oki Yonatan Singal, Anna Maurina Wahyu Ika Wardhani