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Poststroke hyperglycemia: natural history and immediate management
Christopher S Gray1, Anthony J Hildreth, George K M M Alberti
1Department of Geriatric Medicine, University of Newcastle upon Tyne, Sunderland Royal Hospital, Kayll Road, Sunderland, SR4 7TP, England, UK. chris.gray@chs.northy.nhs.uk
Stroke
|December 13, 2003
Summary
Glucose Insulin-Potassium/Insulin (GKI) infusions safely correct poststroke hyperglycemia (PSH) in acute stroke patients. This study provides evidence for GKI
Area of Science:
- Neurology
- Endocrinology
- Clinical Trials
Background:
- Poststroke hyperglycemia (PSH) is common but lacks evidence for routine treatment.
- The Glucose Insulin in Stroke Trial (GIST-UK) is a key source of evidence for managing PSH.
Purpose of the Study:
- To analyze safety-monitoring data from GIST-UK to describe PSH recovery.
- To provide evidence for using glucose/potassium/insulin (GKI) infusions to maintain euglycemia.
Main Methods:
- A multicenter randomized controlled trial (GIST-UK) involving acute stroke patients with mild to moderate hyperglycemia (6.0–17 mmol/L).
- Analysis of capillary and plasma glucose values in patients receiving GKI or saline infusions.
- Evaluation of PSH recovery and GKI regimen effectiveness in maintaining euglycemia.
Main Results:
- Most patients presented with moderate PSH, with spontaneous glucose level decline observed.
- GKI infusions rapidly achieved euglycemia at significantly lower levels compared to saline alone.
- Euglycemia was achieved with a median of 2 GKI regimen adjustments and a low risk of hypoglycemia.
Conclusions:
- GKI infusions, as per the GIST trial protocol, are safe and effective for correcting PSH during the acute stroke phase.
- Further research is needed to determine the clinical benefits of routine hyperglycemia management in stroke.