Persistence and predictors of abnormal glucose metabolisms in patients after acute stroke

To determine the persistence of newly recognized abnormal glucose metabolism in patients following acute ischemic stroke and delineate the possible predictive factors for this persistence.

A prospective observational study was performed. One hundred and twenty-three patients with acute first-ever ischemic stroke and no previous diagnosis of diabetes mellitus were enrolled consecutively. Information from baseline and laboratory tests was recorded. A standard oral glucose tolerance test was performed on the fourteenth day after onset and 3 months later, respectively.

One hundred and seven patients completed the study. Thirty-nine patients (36.3%) were diagnosed as having newly recognized diabetes on the 14th day and 28 patients (26.1%) after 3 months. Among the patients diagnosed as having diabetes or impaired glucose tolerance during hospitalization, 68.6% remained to present with abnormal glucose metabolism 3 months later. Lower post-load plasma glucose on the fourteenth day was detected as a predictor for aggravated glucose metabolism after 3 months of onset.

Majority of newly recognized abnormal glucose metabolism during hospitalization persisted 3 months later. Patients with lower post-load glucose level on the fourteenth day had higher risk for aggravated glucose metabolism 3 months later. Those with higher fasting glucose concentration on admission or higher 2 hour post-load plasma glucose on the fourteenth day had significantly high risk for diabetes after 3 months.