Which option describes the feeding regimen that most effectively stabilizes blood glucose in critically ill patients?

• A. Bolus feeding alone
• B. Intermittent bolus feeding
• C. No insulin
• D. Continuous infusions of enteral feeding and insulin

Answer: (D)

Stability of blood glucose in the critically ill improves when nutrition is delivered continuously and a controlled insulin delivery accompanies it. Continuous enteral feeding provides a steady, predictable substrate, reducing large post‑prandial spikes that happen with bolus feeding. When insulin is delivered as a continuous infusion alongside the continuous feeding, clinicians can titrate insulin to keep glucose within a narrow range, minimizing fluctuations and avoiding both highs and lows. The other approaches tend to produce greater glycemic variability: bolus feeding alone causes peaks after each meal; intermittent bolus feeding leads to oscillations; and without insulin, even steady feeding can result in uncontrollable hyperglycemia. Therefore, continuous enteral feeding with an insulin infusion offers the most effective stabilization of blood glucose in this setting.