DC ORAL 3 - CASE STUDY: SEVERE GLYCOGEN DEPLETION WITH HIGH RISK OF HYPOGLYCEMIA IN CHRONIC MALNOURISHED ELDERLY Siti Nurhana binti Abd Wahid

Siti Nurhana Abd Wahid 1, Basmawati Baharom 2, Fadhlina Abd Samad 2

 

1 International Medical University, Bukit Jalil, Kuala Lumpur

2 Hospital Tuanku Jaafar, Negeri Sembilan

 

Assessment

Elderly male with pulmonary tuberculosis, anemia and hyponatremia was referred to dietitian for provision of regular feeding for increased needs of energy and protein and stabilization of blood sugar. Presented with low BMI and bilateral deafness with no caregiver to assist oral feeding. Prolonged inadequate regular oral intake which reflected in his biochemistries with frequent hypoglycemia. NFPE showed severe chronic malnutrition.

 

Diagnosis

Inadequate energy intake related to decreased ability to consume sufficient energy as evidenced by estimated energy intake from diet less than requirement and limited ability to independently consume foods/fluids (need feeding assistance).

 

Intervention

To provide adequate energy and protein through hospital diet and enteral nutrition support to improve nutritional status and associated outcomes. Energy prescription of 1260kcal/day and 1.24g protein/kg/day delivered enteral nutrition via nasogastric feeding.

 

Monitoring & Evaluation

Toleration of enteral nutrition infusion to improve energy and protein intake with periodic monitoring of lean muscle mass and fat mass store, nutritional biomarkers and blood sugar trend.