Diabetes can significantly increase the risk of post-stroke cognitive impairment (PSCI). Previous studies have shown that diabetes can be involved in the occurrence of cognitive impairment by insulin resistance, blood-brain barrier damage, low level inflammation, β-amyloid deposition and tau phosphorylation, aggravation of ischemic brain injury and oxidative stress. In recent years, the role of diabetes in the pathophysiology of PSCI is attracting increasing attention. This article reviews the correlation between diabetes mellitus and PSCI and the possible pathophysiological mechanisms, hoping to provide reference for prevention and treatment strategies of PSCI in diabetics.

The intestinal flora and the intestinal environment in which it resides together constitute the intestinal microecosystem, it is significantly disturbed in neurocritical ill patients, as manifested by the decrease of bacterial diversity, an increase of pathogen, and the destruction of the intestinal barrier. Appropriate enteral nutrition is effective in maintaining intestinal barrier stability, regulating intestinal immune function, inhibiting intestinal inflammation, and regulating specific intestinal microbiota and intestinal function. It is important for sustaining intestinal microecological balance, reducing clinical complications in patients, and is a new target for the treatment of neurocritical ill patients. This review elaborates the alteration of intestinal microecology and treatment options recommended by current clinical guidelines in neurocritical ill patients and summarizes the research progress of the effects of enteral nutrition and several nutritional additives on intestinal flora and intestinal functions, to provide a reference for the follow-up research.