Insulin is useful for controlling and avoiding hyperglycemia. If it is added to the parenteral nutrition bag, the suggested intake ranges from 1 IU per 10 g glucose in malnourished minimally stressed patients to 1 IU per 4 to 5 g of glucose in severely catabolic patients. When resistance is severe, it is safer to administer insulin (1-3 IU/h) with a syringe pump. Several anabolic agents are effective in, or should improve the efficacy of, the conventional nutritional-metabolic approach to protein metabolism in stress conditions. Hormones like insulin, growth hormone, and insulin-like growth factors are particularly promising ( ^Wllmoie...§nd Carp§ntjer..1994.).
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