Which feeding schedules may cause fluctuations in blood glucose concentrations, increasing risk of hypoglycemia and hyperglycemia?

• A. Intermittent feeding schedules (bolus, gravity drip, or nocturnal infusion)
• B. Continuous infusion
• C. Only nocturnal infusion
• D. No enteral feeding

Answer: (A)

When nutrition is provided in discrete bursts rather than a constant flow, blood glucose tends to rise after each feeding and then fall between feeds. This creates glycemic variability that can push levels into hypoglycemia between feeds or hyperglycemia after feeds, especially for patients on insulin or with impaired glucose tolerance. Intermittent feeding schedules—such as bolus, gravity drip, or nocturnal feeds—produce these peak-and-trough patterns. Continuous infusion, by delivering calories at a steady rate, tends to flatten glucose excursions and reduce the risk of large swings. No enteral feeding would not generate these feeding-related fluctuations (though it would leave caloric needs unmet).