Persistent hyperglycemia >155 mg/dL in acute ischemic stroke patients: How well are we correcting it?: Implications for outcome

Blanca Fuentes, Maria Angeles Ortega-Casarrubios, Belén Sanjosé, José Castillo, Rogelio Leira, Joaquín Serena, José Vivancos, Antonio Dávalos, Antonio Gil-Nuñez, José Egido, Exuperio Díez-Tejedor

    Research output: Contribution to journalArticleResearchpeer-review

    36 Citations (Scopus)

    Abstract

    Background And Purpose-: We aimed to analyze the frequency of persistent hyperglycemia (PH), its implications for outcome, and to document the inpatient management of hyperglycemia. Methods-: Post hoc analysis of the GLIAS (Glycemia in Acute Stroke) study, a multicenter, prospective, and observational cohort study of 476 acute ischemic stroke patients. Capillary finger-prick glucose was determined on admission and during the first 48 hours. We defined PH was defined as at least 2 values ≥155 mg/dL. Outcome (modified Rankin Scale) was evaluated at 3 months. Results-: PH developed in 117 patients (24.7%). PH was associated with poorer outcome (modified Rankin Scale score >2: 56.2% vs 28.1%; P<0.01) and higher mortality (26.7% vs 5.9%; P<0.01) than those with glycemia <155 mg/dL. PH ≥155 mg/dL was associated with a 4-fold increase in the odds of poor outcome at 3 months (odds ratio, 4.7; 95% confidence interval, 2.2-10.2) after adjustment for age, gender, hypertension, diabetes, stroke severity, admission glycemia, and infarct volume. Only 20% of patients with hyperglycemia ≥155 mg/dL received insulin on admission, with a progressive increase in the use of insulin during the following 48 hours. However, 114 (39.1%) out of 291 patients who received corrective treatment for hyperglycemia still had levels ≥155 mg/dL. Conclusions-: PH ≥155 mg/dL is a common observation in acute ischemic stroke patients that is associated with poorer outcome and higher mortality. Almost 40% of patients maintained levels ≥155 mg/dL despite corrective treatment. © 2010 American Heart Association, Inc.
    Original languageEnglish
    Pages (from-to)2362-2365
    JournalStroke
    Volume41
    Issue number10
    DOIs
    Publication statusPublished - 1 Oct 2010

    Keywords

    • acute stroke
    • outcome
    • persistent hyperglycemia

    Fingerprint Dive into the research topics of 'Persistent hyperglycemia >155 mg/dL in acute ischemic stroke patients: How well are we correcting it?: Implications for outcome'. Together they form a unique fingerprint.

  • Cite this

    Fuentes, B., Angeles Ortega-Casarrubios, M., Sanjosé, B., Castillo, J., Leira, R., Serena, J., Vivancos, J., Dávalos, A., Gil-Nuñez, A., Egido, J., & Díez-Tejedor, E. (2010). Persistent hyperglycemia >155 mg/dL in acute ischemic stroke patients: How well are we correcting it?: Implications for outcome. Stroke, 41(10), 2362-2365. https://doi.org/10.1161/STROKEAHA.110.591529