Glycemic Control in Patients with Acute Stroke: The Significance of Nursing Management

Abstract

Introduction: Glucose deregulation during the acute phase of the Ischemic Stroke is common. Moreover, hyperglycemia is most commonly observed in both diabetic and non-diabetic patients. Yet, what is not known as yet, is whether hyperglycemia is simply an expression of the infarction’s severity, thus, reflecting the magnitude of the damage, or it may have a negative effect on the ischemic region as an independent factor. Aim: The purpose of this review is to investigate the factors leading to glucose deregulation following stroke and the need for systematic nursing care and intervention. Material and Μethod: A search was carried out on the bibliographical bases of Medline, Google Scholar, Science Direct and Cinahl. The English terms "stroke", "glucose", "glucose fluctuation", "glucose management", "hyperglycemia", "stress hyperglycemia" were used. Review articles, meta-analyzes and clinical studies published from 2000 to 2019, were included in this review. Results: 2/3 of patients with acute stroke present with increased glucose over the first 24 hours post onset. This may be due to existing diabetes, or it may be due to stress. In addition, intestinal and parenteral nutrition, corticotherapy and activity limitation are factors affecting normoglymphemia. Several studies have supported the independent effect of hyperglycemia on the ischemic region to be considered as a bad predictor for the outcome of stroke. Conclusions: All patients with stroke should be treated as potentially diabetic and introduced directly into systemic monitoring. Maintaining glucose levels may reduce mortality and disability and nurses may play a key role in achieving this.