The study investigated the relationship between gut microbiota, GLP-1 (glucagon-like peptide-1) and enteral feeding (FI) intolerance in 60 critically ill neurological patients. Analysis of stool samples revealed that patients with FI had early dysbiosis and reduced gut microbiota diversity. At a later stage, the number of bacteria of the genus Bacteroidetes decreased and the incidence of enterococci increased in patients with FI. The study identified the regulatory axis "intestinal microbiota – GLP-1 – blood glucose". Early alpha diversity and presence of specific bacteria may serve as predictive biomarkers for FI. Targeting the gut microbiota and GLP-1 pathways could improve enteral feeding tolerance in these patients.