A Prospective, Observational Study of the Management of Hyperglycaemia in Acute Stroke. What is the Optimum Level of Blood Glucose at which to Intervene?

Author:

Grant Paul S1,Ali Khalid2

Affiliation:

1. Department of Diabetes and Endocrinology, Royal Sussex County Hospital, Brighton, UK.

2. Department of Academic Medicine, Brighton and Sussex Medical Schools, Brighton, UK.

Abstract

Background It is well known that blood glucose levels are increased in the first 12 hours after the onset of acute stroke. The magnitude of the rise is supposedly related to the severity of the stroke and this is in turn associated with a worse prognosis. Several guidelines advocate the use of insulin sliding scales in the acute stroke setting but these are only implemented with varying degrees of success. There is no clear evidence base as to the glycaemic level at which to intervene and the significance of the intervention on outcomes. Methods We prospectively reviewed the treatment of 229 patients admitted to a stroke unit and compared admission blood glucose results with stroke prognostic/neurological deficit score (National Institutes of Health Stroke Scale) at 30 days. Inter-physician practice variability allowed us to observe the outcomes when different levels for intervention were used (and allowed us to calculate an optimum level of glucose at which insulin sliding scale treatment would lead to most benefit). Results We showed that glucose is a modifiable factor that has implications for long-term stroke outcomes. Conclusion The suggested level for intervention with insulin (admission blood glucose of ≥ 10.1 mmol/L) is lower than previously thought.

Publisher

SAGE Publications

Subject

Cardiology and Cardiovascular Medicine,Endocrinology, Diabetes and Metabolism,Internal Medicine

Cited by 5 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3