Evidence summary for optimal glycemic variability management during enteral nutrition in adult ICU patients with cerebral infarction

Objective: To systematically summarize the best available evidence on glycemic variability (GV) management during enteral nutrition (EN) in adult patients with cerebral infarction in the intensive care unit (ICU), and to provide an evidence-based reference for clinical practice. Methods: Guided by the 6S evidence-based model, this evidence summary systematically searched Chinese and English evidence-based resource databases, guideline websites, professional society websites, and literature databases from inception to April 1, 2026. Eligible documents were critically appraised using source-specific tools, and the best available evidence was extracted, graded, and synthesized. Results: A total of 18 documents were included, comprising 9 guidelines, 2 expert consensuses, 3 clinical decisions, 3 best evidence summaries and 1 systematic review. Thirty-five pieces of best evidence were summarized across five domains: basic patient assessment and screening, blood glucose monitoring and target control, optimization of enteral nutrition regimens, insulin intervention strategies, and multidisciplinary collaborative management. Conclusion: This study summarizes the best available evidence for GV management during EN in adult patients with cerebral infarction in the ICU. In clinical practice, individualized adjustments should be made according to patient conditions and local resource availability to improve the quality of GV management. Systematic review registration: This evidence summary has been registered at the Evidence Summary Registration Platform of Fudan University Centre for Evidence-Based Nursing. The registration details are as follows: Unique Identifier: ES20269922. Title: Evidence Summary of Glycemic Variability Management During Enteral Nutrition in Patients With Cerebral Infarction Registration date: 2026-02-13. The publicly accessible registration platform URL is: http://ebn.nursing.fudan.edu.cn/home.