Application effect of individualized dietary care based on multidisciplinary collaboration model in stroke patients with abnormal blood glucose levels_West China Medical Journal

Authors：

ZHONG Jieping ^1,2 , QIN Lianhua ^1,2 , ZHANG Yiling ^1,2 , HE Bingyi ^1,2 , LIU Xu ² ,  YAN Bo ^1,2

1. Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Department of Neurology, Shangjin Hospital, West China Hospital, Sichuan University, Chengdu 611730, P. R. China;

Corresponding author：

YAN Bo, Email: yanbo96@163.com

Keywords：

Multidisciplinary collaboration model; individualized dietary care; stroke; abnormal blood glucose

DOI：

10.7507/1002-0179.202504200

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To investigate the application effect of ndividualized dietary care based on a multidisciplinary collaboration model on glycemic control, neurological recovery, dietary self-management, and satisfaction in stroke patients with abnormal blood glucose. Methods Patients with stroke and abnormal blood glucose admitted to the Department of Neurology, Shangjin Hospital, West China Hospital, Sichuan University between March and October 2024 were enrolled. Using SPSS 26.0 software, a random allocation sequence was generated to divide participants into an observation group and a control group. The control group received comprehensive nursing interventions, while the observation group received additional multidisciplinary collaboration model based individualized dietary care. Both groups were intervened until discharge. Glycemic indicators [glycated albumin (GA), fasting blood glucose (FBG), 2-hour postprandial blood glucose (2hPG)], neurological recovery, dietary adherence, and patient satisfaction were compared pre-intervention and post-intervention (at discharge). Results A total of 112 patients were included, with 56 patients in each group. At the post-intervention stage, GA, FBG and 2hPG in the observation group were lower than those in the control group (P<0.05), and the scores of the Dietary Compliance Scale for Type 2 Diabetes were higher than those in the control group (P<0.05). Except for admission (3.27±0.86 vs. 3.25±0.90, P＞0.05), the modified Rankin Scale scores of the observation group were lower than those of the control group at discharge (3.14±0.86 vs. 3.17±0.86), 30-days follow-up (2.93±0.76 vs. 3.02±0.84), and 90-days follow-up (1.05±0.80 vs.1.43±1.01) (P<0.05). The comparison results within the group showed that, there were significant differences in GA, FBG, 2hPG, modified Rankin Scale scores and Dietary Compliance Scale for Type 2 Diabetes between admission and discharge (P<0.05). The satisfaction rate of the observation group was higher than that of the control group (97.78% vs. 86.76%; χ²=3.877, P=0.049). Conclusions Multidisciplinary collaboration model based individualized dietary care improves short-term glycemic control, promotes long-term neurological recovery, enhances dietary adherence, and increases patient satisfaction in stroke patients with abnormal blood glucose, demonstrating clinical value for widespread application.

1.	GBD 2019 Stroke Collaborators. Global, regional, and national burden of stroke and its risk factors, 1990-2019: a systematic analysis for the global burden of disease study 2019. Lancet Neurol, 2021, 20(10): 795-820.
2.	《2 型糖尿病患者卒中预防及血糖管理专家共识》编写委员会. 2 型糖尿病患者卒中预防及血糖管理专家共识. 中华内科杂志, 2024, 63(7): 649-659.
3.	Powers WJ, Rabinstein AA, Ackerson T, et al. Guidelines for the early management of patients with acute ischemic stroke: 2019 update to the 2018 guidelines for the early management of acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke, 2019, 50(12): e344-e418.
4.	Wolf V, Abdul Y, Li W, et al. Impact of diabetes and ischemic stroke on the cerebrovasculature: a female perspective. Neurobiol Dis, 2022, 167: 105667.
5.	Samson SL, Vellankip, Blondel, et al. American association of clinical endocrinology consensus statement: comprehensive type 2 diabetes management algorithm-2023 update. Endocr Pract, 2023, 29(5): 305-340.
6.	陈向阳, 李舍予. 非内分泌病房住院糖尿病患者的血糖管理. 中国全科医学, 2023, 26(15): 1799-1803.
7.	冯晓琴, 卞丽虹, 翁美文妹. 多学科协作延续性护理对糖尿病视网膜病变合并高血压患者的效果分析. 心血管病防治知识, 2023, 13(26): 39-41, 44.
8.	中华医学会神经病学分会, 中华医学会神经病学分会脑血管病学组. 中国缺血性卒中和短暂性脑缺血发作二级预防指南 2022. 中华神经科杂志, 2022, 55(10): 1071-1110.
9.	中华医学会, 中华医学会杂志社, 中华医学会全科医学分会, 等. 缺血性卒中基层诊疗指南(2021 年). 中华全科医师杂志, 2021, 20(9): 927-946.
10.	胡周全, 江朋, 唐勇, 等. 全身免疫炎症指数及美国国立卫生研究院卒中量表评分对急性缺血性脑卒中患者静脉溶栓后短期预后的评估效力分析. 华西医学, 2024, 39(5): 699-704.
11.	中国卒中学会神经介入分会. 始发表现为轻型卒中的急性大血管闭塞的血管内治疗中国专家共识 2023. 中国卒中杂志, 2023, 18(12): 1429-1449.
12.	谭丽梅, 兰希发, 祖艳颖. 基于改良 Rankin 量表评分分析青年缺血性脑卒中患者预后不良的相关影响因素. 中国临床医生杂志, 2023, 51(10): 1164-1166.
13.	周丹, 高岩, 包乌仁, 等. 2 型糖尿病患者饮食行为依从性量表的编制及信效度研究. 中国卫生统计, 2021, 38(3): 409-410, 415.
14.	周芳馨, 任国勇, 郭雅芹, 等. 应激性高血糖比值对缺血性脑卒中预后的预测价值的研究进展. 安徽医药, 2024, 28(11): 2135-2140.
15.	Baird TA, Parsons MW, Phan T, et al. Persistent poststroke hyperglycemia is independently associated with infarct expansion and worse clinical outcome. Stroke, 2003, 34(9): 2208-2214.
16.	Capes SE, Hunt D, Malmberg K, et al. Stress hyperglycemia and prognosis of stroke in nondiabetic and diabetic patients: a systematic overview. Stroke, 2001, 32(10): 2426-2432.
17.	Liu HF, Xin XQ, Gan J, et al. The long-term effects of blood urea nitrogen levels on cardiovascular disease and all-cause mortality in diabetes: a prospective cohort study. BMC Cardiovasc Disord, 2024, 24(1): 256.
18.	Tu WJ, Wang LD; Special writing group of china stroke Surveillance Report. China stroke surveillance report 2021. Mil Med Res, 2023, 10(1): 33.
19.	Powers WJ, Rabinstein AA, Ackerson T, et al. 2018 Guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke, 2018, 49(3): e46-e110.
20.	中华医学会神经病学分会, 中华医学会神经病学分会脑血管病学组. 中国急性缺血性脑卒中诊治指南 2018. 中华神经科杂志, 2018, 51(9): 666-682.
21.	American Diabetes Association Professional Practice Committee. 4. comprehensive medical evaluation and assessment of comorbidities: standards of care in diabetes-2024. Diabetes Care, 2024, 47 (Suppl1): S52-S76.
22.	崔灿, 陈艳红, 张蕊, 等. 淮海地区不同年龄人群糖化血清白蛋白参考区间的建立. 检验医学, 2020, 35(3): 229-232.
23.	罗金花, 何来鹏, 袁满. 糖化血清白蛋白对糖尿病诊断价值的 meta 分析. 中国当代医药, 2021, 28(32): 23-27.
24.	侯崇, 肖斌. 缺血性脑卒中合并 2 型糖尿病患者入院早期血糖波动对脑神经功能缺损的影响. 中国卫生工程学, 2025, 34(1): 104-106.
25.	Perry RJ, Wang YL, Cline GW, et al. Leptin mediates a glucose-fatty acid cycle to maintain glucose homeostasis in starvation. Cell, 2018, 172(1/2): 234-248.e17.
26.	耿扬博, 阚云龙, 唐敏华, 等. 缺血性脑卒中患者空腹血糖水平与死亡风险的关联研究. 中国初级卫生保健, 2025, 39(1): 43-46, 65.
27.	朱婵, 张强, 陈秋. 糖尿病与缺血性卒中: 病理生理机制及药物研究现状. 华西医学, 2024, 39(11): 1815-1820.

1. GBD 2019 Stroke Collaborators. Global, regional, and national burden of stroke and its risk factors, 1990-2019: a systematic analysis for the global burden of disease study 2019. Lancet Neurol, 2021, 20(10): 795-820.
2. 《2 型糖尿病患者卒中预防及血糖管理专家共识》编写委员会. 2 型糖尿病患者卒中预防及血糖管理专家共识. 中华内科杂志, 2024, 63(7): 649-659.
3. Powers WJ, Rabinstein AA, Ackerson T, et al. Guidelines for the early management of patients with acute ischemic stroke: 2019 update to the 2018 guidelines for the early management of acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke, 2019, 50(12): e344-e418.
4. Wolf V, Abdul Y, Li W, et al. Impact of diabetes and ischemic stroke on the cerebrovasculature: a female perspective. Neurobiol Dis, 2022, 167: 105667.
5. Samson SL, Vellankip, Blondel, et al. American association of clinical endocrinology consensus statement: comprehensive type 2 diabetes management algorithm-2023 update. Endocr Pract, 2023, 29(5): 305-340.
6. 陈向阳, 李舍予. 非内分泌病房住院糖尿病患者的血糖管理. 中国全科医学, 2023, 26(15): 1799-1803.
7. 冯晓琴, 卞丽虹, 翁美文妹. 多学科协作延续性护理对糖尿病视网膜病变合并高血压患者的效果分析. 心血管病防治知识, 2023, 13(26): 39-41, 44.
8. 中华医学会神经病学分会, 中华医学会神经病学分会脑血管病学组. 中国缺血性卒中和短暂性脑缺血发作二级预防指南 2022. 中华神经科杂志, 2022, 55(10): 1071-1110.
9. 中华医学会, 中华医学会杂志社, 中华医学会全科医学分会, 等. 缺血性卒中基层诊疗指南(2021 年). 中华全科医师杂志, 2021, 20(9): 927-946.
10. 胡周全, 江朋, 唐勇, 等. 全身免疫炎症指数及美国国立卫生研究院卒中量表评分对急性缺血性脑卒中患者静脉溶栓后短期预后的评估效力分析. 华西医学, 2024, 39(5): 699-704.
11. 中国卒中学会神经介入分会. 始发表现为轻型卒中的急性大血管闭塞的血管内治疗中国专家共识 2023. 中国卒中杂志, 2023, 18(12): 1429-1449.
12. 谭丽梅, 兰希发, 祖艳颖. 基于改良 Rankin 量表评分分析青年缺血性脑卒中患者预后不良的相关影响因素. 中国临床医生杂志, 2023, 51(10): 1164-1166.
13. 周丹, 高岩, 包乌仁, 等. 2 型糖尿病患者饮食行为依从性量表的编制及信效度研究. 中国卫生统计, 2021, 38(3): 409-410, 415.
14. 周芳馨, 任国勇, 郭雅芹, 等. 应激性高血糖比值对缺血性脑卒中预后的预测价值的研究进展. 安徽医药, 2024, 28(11): 2135-2140.
15. Baird TA, Parsons MW, Phan T, et al. Persistent poststroke hyperglycemia is independently associated with infarct expansion and worse clinical outcome. Stroke, 2003, 34(9): 2208-2214.
16. Capes SE, Hunt D, Malmberg K, et al. Stress hyperglycemia and prognosis of stroke in nondiabetic and diabetic patients: a systematic overview. Stroke, 2001, 32(10): 2426-2432.
17. Liu HF, Xin XQ, Gan J, et al. The long-term effects of blood urea nitrogen levels on cardiovascular disease and all-cause mortality in diabetes: a prospective cohort study. BMC Cardiovasc Disord, 2024, 24(1): 256.
18. Tu WJ, Wang LD; Special writing group of china stroke Surveillance Report. China stroke surveillance report 2021. Mil Med Res, 2023, 10(1): 33.
19. Powers WJ, Rabinstein AA, Ackerson T, et al. 2018 Guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke, 2018, 49(3): e46-e110.
20. 中华医学会神经病学分会, 中华医学会神经病学分会脑血管病学组. 中国急性缺血性脑卒中诊治指南 2018. 中华神经科杂志, 2018, 51(9): 666-682.
21. American Diabetes Association Professional Practice Committee. 4. comprehensive medical evaluation and assessment of comorbidities: standards of care in diabetes-2024. Diabetes Care, 2024, 47 (Suppl1): S52-S76.
22. 崔灿, 陈艳红, 张蕊, 等. 淮海地区不同年龄人群糖化血清白蛋白参考区间的建立. 检验医学, 2020, 35(3): 229-232.
23. 罗金花, 何来鹏, 袁满. 糖化血清白蛋白对糖尿病诊断价值的 meta 分析. 中国当代医药, 2021, 28(32): 23-27.
24. 侯崇, 肖斌. 缺血性脑卒中合并 2 型糖尿病患者入院早期血糖波动对脑神经功能缺损的影响. 中国卫生工程学, 2025, 34(1): 104-106.
25. Perry RJ, Wang YL, Cline GW, et al. Leptin mediates a glucose-fatty acid cycle to maintain glucose homeostasis in starvation. Cell, 2018, 172(1/2): 234-248.e17.
26. 耿扬博, 阚云龙, 唐敏华, 等. 缺血性脑卒中患者空腹血糖水平与死亡风险的关联研究. 中国初级卫生保健, 2025, 39(1): 43-46, 65.
27. 朱婵, 张强, 陈秋. 糖尿病与缺血性卒中: 病理生理机制及药物研究现状. 华西医学, 2024, 39(11): 1815-1820.

West China Medical Journal

Latest ArticlesApplication effect of individualized dietary care based on multidisciplinary collaboration model in stroke patients with abnormal blood glucose levels

Abstract Full text Figures/Tables Video References Cited by

Format

Content