Document Detail

Management of diabetes during acute stroke and inpatient stroke rehabilitation.
MedLine Citation:
PMID:  16344038     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: To summarize evidence on the impact of hyperglycemia on stroke outcomes and to present therapy algorithms for inpatient management in diabetic stroke patients. DATA SOURCES: Guidelines for inpatient management of diabetes were reviewed and extracted from a technical review and recommendations from 2 national diabetes and endocrine organizations. MEDLINE database searches were conducted using key words: stroke, diabetes, hyperglycemia, hypoglycemia, inpatient, hospitalized, treatment, outcomes, disability, self-management, and education. STUDY SELECTION: Studies were selected that specifically addressed the impact of the following in stroke patients: hyperglycemia and diabetes on rehabilitation outcomes, management strategies for hyperglycemia and diabetes, and strategies for facilitating diabetes self-management. DATA EXTRACTION: Two authors independently extracted data and management practices from selected articles and published practice guidelines. DATA SYNTHESIS: Diabetes is prevalent in stroke patients and results in poorer inpatient hospital and rehabilitation outcomes. Management of diabetes in stroke patients is further complicated by impairments in mobility and vision, necessitating accommodation strategies and tools for self-management. Optimal management of hyperglycemia using insulin or oral hypoglycemic agents results in reduced morbidity and mortality among diabetic inpatients. CONCLUSIONS: To achieve inpatient glycemic management targets, use of clinical management algorithms, self-management tools, and systems approaches such as diabetes management teams are useful.
Sherita Hill Golden; Felicia Hill-Briggs; Kathleen Williams; Karen Stolka; R Samuel Mayer
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Archives of physical medicine and rehabilitation     Volume:  86     ISSN:  0003-9993     ISO Abbreviation:  Arch Phys Med Rehabil     Publication Date:  2005 Dec 
Date Detail:
Created Date:  2005-12-13     Completed Date:  2006-02-08     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  2985158R     Medline TA:  Arch Phys Med Rehabil     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2377-84     Citation Subset:  AIM; IM    
Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA.
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MeSH Terms
Biomedical Research
Deglutition Disorders / therapy
Diabetes Complications
Diabetes Mellitus / drug therapy*,  physiopathology
Hypoglycemic Agents / therapeutic use*
Practice Guidelines as Topic
Self Care
Stroke / complications,  rehabilitation*
Grant Support
1 K01 HL076644-01/HL/NHLBI NIH HHS; 3 U01 DK48485-10S1/DK/NIDDK NIH HHS
Reg. No./Substance:
0/Hypoglycemic Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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