Related Experiment Video

Updated: Jun 18, 2026

Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure
05:16

Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure

Published on: June 10, 2025

Baseline diabetic status and admission blood glucose were poor prognostic factors in the EPITHET trial

D A De Silva1, M Ebinger, S Christensen

  • 1The Royal Melbourne Hospital, Melbourne, Australia.

Cerebrovascular Diseases (Basel, Switzerland)
|November 7, 2009
PubMed

Insights

Diabetes and high blood sugar levels worsen stroke outcomes and reduce the effectiveness of tissue plasminogen activator (tPA) treatment. Stratifying patients by diabetic status is crucial for future thrombolytic trials.

Area of Science:

  • Neurology
  • Endocrinology
  • Cardiovascular Research

Background:

  • Existing research indicates that diabetes and hyperglycemia are associated with adverse outcomes after stroke.
  • The prognostic significance of diabetes and admission blood glucose levels in stroke patients was investigated.

Purpose of the Study:

  • To evaluate the impact of diabetes and admission blood glucose on stroke outcomes within the Echoplanar Imaging Thrombolytic Evaluation Trial (EPITHET).
  • To determine if diabetic status influences the efficacy of intravenous tissue plasminogen activator (tPA).

Main Methods:

  • Analysis of data from the EPITHET trial, a prospective, randomized, placebo-controlled study.
  • Patients received intravenous tPA within a 3- to 6-hour time window post-stroke.
  • Preexisting diabetes diagnosis and baseline serum glucose levels were recorded for all participants.

Main Results:

  • Intravenous tPA demonstrated efficacy in attenuating infarct growth in non-diabetic patients but not in diabetic patients (p = 0.029).
  • Within the tPA treatment group, patients with poor functional outcomes had significantly higher admission blood glucose levels (p = 0.002).

Conclusions:

  • Diabetes and hyperglycemia diminish the therapeutic effects of tPA on infarct evolution.
  • Future thrombolytic trials should incorporate patient stratification based on diabetic status and serum glucose levels for more precise outcome assessment.
Abstract

More Related Videos

Improving IV Insulin Administration in a Community Hospital12:08

Improving IV Insulin Administration in a Community Hospital

Published on: June 11, 2012

Characterization of Metabolic Status in Nonhuman Primates with the Intravenous Glucose Tolerance Test06:59

Characterization of Metabolic Status in Nonhuman Primates with the Intravenous Glucose Tolerance Test

Published on: November 13, 2016

Related Concept Videos

Diabetic Nephropathy01:28

Diabetic Nephropathy

Definition Diabetic nephropathy is a chronic kidney complication that results from prolonged hyperglycemia.Prevalence It is the most common cause of chronic kidney disease (CKD) and end-stage renal disease (ESRD) worldwide, affecting up to half of individuals with diabetes.Pathophysiology • Sustained hyperglycemia triggers multiple hemodynamic and metabolic changes in the kidney. • Early in the disease, increased renal blood flow and glomerular hyperfiltration occur due to afferent arteriolar...
Type II Diabetes Mellitus III: Clinical Manifestations and Diagnosis01:25

Type II Diabetes Mellitus III: Clinical Manifestations and Diagnosis

Type 2 diabetes mellitus develops gradually and is often asymptomatic in early stages.Clinical ManifestationsWhen symptoms appear, they include fatigue, blurred vision, pruritus, delayed wound healing, and recurrent infections, particularly candidal infections. Peripheral neuropathy may present as numbness or tingling in the extremities. Classic hyperglycemia symptoms—polyuria, polydipsia, and polyphagia—are less common. Most patients are overweight and frequently have associated hypertension...
Diabetes: Symptoms, Diagnosis, and Complications01:15

Diabetes: Symptoms, Diagnosis, and Complications

For most patients, experiencing several weeks of polyuria, polydipsia, fatigue, and significant weight loss may indicate the presence of diabetes. Furthermore, adults displaying the phenotypic appearance of type 2 diabetes (particularly those who are obese and not initially insulin-requiring), may have islet cell autoantibodies, suggesting autoimmune-mediated β cell destruction and a diagnosis of latent autoimmune diabetes of adults (LADA). The categorization of glucose homeostasis is based on...
Diabetes Mellitus: Type 2 and Gestational01:22

Diabetes Mellitus: Type 2 and Gestational

Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
Hyperglycemia01:29

Hyperglycemia

Hyperglycemia is an abnormally high blood glucose level. It is diagnosed by fasting glucose ≥126 mg/dL, 2-hour oral glucose tolerance test (or OGTT) ≥200 mg/dL, random glucose ≥200 mg/dL with symptoms, or HbA1c ≥6.5%. However, HbA1c results may be unreliable in certain conditions, such as anemia or hemoglobinopathies, and the diagnosis should be confirmed unless classic symptoms are present. Postprandial hyperglycemia is typically considered significant when glucose levels exceed 180 mg/dL two...
Type II Diabetes II: Pathophysiology01:24

Type II Diabetes II: Pathophysiology

PathophysiologyType 2 diabetes mellitus (T2DM ) is a chronic metabolic disorder characterized by insulin resistance and progressive pancreatic β-cell dysfunction, leading to impaired glucose homeostasis. It results from interactions among genetic predisposition, environmental factors, and metabolic stressors, such as overnutrition and a sedentary lifestyle.Insulin Resistance and Glucose DysregulationEarly T2DM involves insulin resistance in skeletal muscle, adipose tissue, and the liver.