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Glycaemic management during the inpatient enteral feeding of stroke patients with diabetes (Aug 2012)

A diagnosis of diabetes at least doubles the risk of stroke. Thus a considerable proportion of patients presenting to hospital with acute stroke will have Type 2 diabetes, and less commonly Type 1 diabetes. An estimated 150,000 people suffer a stroke in the UK every year, occupying around 20 per cent of all acute hospital beds and 25 per cent of long-term beds.

A standard approach to the management of patients with stroke is the provision of adequate nutrition. Frequently this involves a period of enteral feeding should the stroke have resulted in an impaired ability to swallow food safely.

There is currently considerable variability in the management of diabetes inpatients fed enterally following a stroke. Variation in the inpatient management of hyperglycaemia and hypoglycaemia in people receiving enteral feeding following stroke may worsen patient recovery and the potential for rehabilitation.

The aim of this document, produced by the Joint British Diabetes Societies for Inpatient Care (JBDS-IP) is to provide guidance to multidisciplinary teams (MDT) – general physicians and stroke specialists, general medical ward and stroke unit nursing staff, dietitians and nutrition teams. It aims to provide pragmatic guidance for the inpatient management of people with stroke who have diabetes and who require a period of enteral feeding in order to improve patient outcomes and patient experience.

JBDS-IP is supported by Diabetes UK, the Association of British Clinical Diabetologists (ABCD) and the Diabetes Inpatient Specialist Nurse UK Group. The aim of JBDS-IP is to improve inpatient diabetes care throughout the UK. This is mainly through the development and use of high quality evidence based guidelines, and through better inpatient care pathways.

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