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 611743, 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：

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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). Conclusion 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.

Citation： ZHONG Jieping, QIN Lianhua, ZHANG Yiling, HE Bingyi, LIU Xu, YAN Bo. Application effect of individualized dietary care based on multidisciplinary collaboration model in stroke patients with abnormal blood glucose levels. West China Medical Journal, 2025, 40(5): 704-709. doi: 10.7507/1002-0179.202504200 Copy

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 型糖尿病患者卒中預防及血糖管理專家共識》編寫委員會. 2 型糖尿病患者卒中預防及血糖管理專家共識. 中華內科雜志, 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.	陳向陽, 李舍予. 非內分泌病房住院糖尿病患者的血糖管理. 中國全科醫學, 2023, 26(15): 1799-1803.
7.	馮曉琴, 卞麗虹, 翁美文妹. 多學科協作延續性護理對糖尿病視網膜病變合并高血壓患者的效果分析. 心血管病防治知識, 2023, 13(26): 39-41, 44.
8.	中華醫學會神經病學分會, 中華醫學會神經病學分會腦血管病學組. 中國缺血性卒中和短暫性腦缺血發作二級預防指南 2022. 中華神經科雜志, 2022, 55(10): 1071-1110.
9.	中華醫學會, 中華醫學會雜志社, 中華醫學會全科醫學分會, 等. 缺血性卒中基層診療指南(2021 年). 中華全科醫師雜志, 2021, 20(9): 927-946.
10.	胡周全, 江朋, 唐勇, 等. 全身免疫炎癥指數及美國國立衛生研究院卒中量表評分對急性缺血性腦卒中患者靜脈溶栓后短期預后的評估效力分析. 華西醫學, 2024, 39(5): 699-704.
11.	中國卒中學會神經介入分會. 始發表現為輕型卒中的急性大血管閉塞的血管內治療中國專家共識 2023. 中國卒中雜志, 2023, 18(12): 1429-1449.
12.	譚麗梅, 蘭希發, 祖艷穎. 基于改良 Rankin 量表評分分析青年缺血性腦卒中患者預后不良的相關影響因素. 中國臨床醫生雜志, 2023, 51(10): 1164-1166.
13.	周丹, 高巖, 包烏仁, 等. 2 型糖尿病患者飲食行為依從性量表的編制及信效度研究. 中國衛生統計, 2021, 38(3): 409-410, 415.
14.	周芳馨, 任國勇, 郭雅芹, 等. 應激性高血糖比值對缺血性腦卒中預后的預測價值的研究進展. 安徽醫藥, 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.	中華醫學會神經病學分會, 中華醫學會神經病學分會腦血管病學組. 中國急性缺血性腦卒中診治指南 2018. 中華神經科雜志, 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.	崔燦, 陳艷紅, 張蕊, 等. 淮海地區不同年齡人群糖化血清白蛋白參考區間的建立. 檢驗醫學, 2020, 35(3): 229-232.
23.	羅金花, 何來鵬, 袁滿. 糖化血清白蛋白對糖尿病診斷價值的 meta 分析. 中國當代醫藥, 2021, 28(32): 23-27.
24.	侯崇, 肖斌. 缺血性腦卒中合并 2 型糖尿病患者入院早期血糖波動對腦神經功能缺損的影響. 中國衛生工程學, 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.	耿揚博, 闞云龍, 唐敏華, 等. 缺血性腦卒中患者空腹血糖水平與死亡風險的關聯研究. 中國初級衛生保健, 2025, 39(1): 43-46, 65.
27.	朱嬋, 張強, 陳秋. 糖尿病與缺血性卒中: 病理生理機制及藥物研究現狀. 華西醫學, 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 型糖尿病患者卒中預防及血糖管理專家共識》編寫委員會. 2 型糖尿病患者卒中預防及血糖管理專家共識. 中華內科雜志, 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. 陳向陽, 李舍予. 非內分泌病房住院糖尿病患者的血糖管理. 中國全科醫學, 2023, 26(15): 1799-1803.
7. 馮曉琴, 卞麗虹, 翁美文妹. 多學科協作延續性護理對糖尿病視網膜病變合并高血壓患者的效果分析. 心血管病防治知識, 2023, 13(26): 39-41, 44.
8. 中華醫學會神經病學分會, 中華醫學會神經病學分會腦血管病學組. 中國缺血性卒中和短暫性腦缺血發作二級預防指南 2022. 中華神經科雜志, 2022, 55(10): 1071-1110.
9. 中華醫學會, 中華醫學會雜志社, 中華醫學會全科醫學分會, 等. 缺血性卒中基層診療指南(2021 年). 中華全科醫師雜志, 2021, 20(9): 927-946.
10. 胡周全, 江朋, 唐勇, 等. 全身免疫炎癥指數及美國國立衛生研究院卒中量表評分對急性缺血性腦卒中患者靜脈溶栓后短期預后的評估效力分析. 華西醫學, 2024, 39(5): 699-704.
11. 中國卒中學會神經介入分會. 始發表現為輕型卒中的急性大血管閉塞的血管內治療中國專家共識 2023. 中國卒中雜志, 2023, 18(12): 1429-1449.
12. 譚麗梅, 蘭希發, 祖艷穎. 基于改良 Rankin 量表評分分析青年缺血性腦卒中患者預后不良的相關影響因素. 中國臨床醫生雜志, 2023, 51(10): 1164-1166.
13. 周丹, 高巖, 包烏仁, 等. 2 型糖尿病患者飲食行為依從性量表的編制及信效度研究. 中國衛生統計, 2021, 38(3): 409-410, 415.
14. 周芳馨, 任國勇, 郭雅芹, 等. 應激性高血糖比值對缺血性腦卒中預后的預測價值的研究進展. 安徽醫藥, 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. 中華醫學會神經病學分會, 中華醫學會神經病學分會腦血管病學組. 中國急性缺血性腦卒中診治指南 2018. 中華神經科雜志, 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. 崔燦, 陳艷紅, 張蕊, 等. 淮海地區不同年齡人群糖化血清白蛋白參考區間的建立. 檢驗醫學, 2020, 35(3): 229-232.
23. 羅金花, 何來鵬, 袁滿. 糖化血清白蛋白對糖尿病診斷價值的 meta 分析. 中國當代醫藥, 2021, 28(32): 23-27.
24. 侯崇, 肖斌. 缺血性腦卒中合并 2 型糖尿病患者入院早期血糖波動對腦神經功能缺損的影響. 中國衛生工程學, 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. 耿揚博, 闞云龍, 唐敏華, 等. 缺血性腦卒中患者空腹血糖水平與死亡風險的關聯研究. 中國初級衛生保健, 2025, 39(1): 43-46, 65.
27. 朱嬋, 張強, 陳秋. 糖尿病與缺血性卒中: 病理生理機制及藥物研究現狀. 華西醫學, 2024, 39(11): 1815-1820.

West China Medical Journal

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

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