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Treatment of hyperglycaemia in patients with acute stroke

L Castilla-Guerra1, M C Fernández-Moreno2, J Hewitt3

  • 1Servicio de Medicina Interna, Hospital de la Merced, Osuna, Sevilla, España.

Revista Clinica Espanola
|July 21, 2015
PubMed

Insights

Diabetic patients increasingly experience strokes, with many showing high blood sugar. Current evidence does not support intravenous insulin for acute stroke, but ongoing research may clarify glucose control benefits.

Area of Science:

  • Neurology
  • Endocrinology
  • Public Health

Background:

  • Increasing hospitalizations for stroke among diabetic patients, now nearly one-third of all stroke cases.
  • Approximately 50% of acute stroke patients exhibit hyperglycemia within the initial hours.
  • Acute phase hyperglycemia in stroke is linked to poorer patient outcomes, yet its treatment remains controversial.

Purpose of the Study:

  • To review the current understanding of hyperglycemia in acute stroke patients.
  • To discuss the debated role of intravenous insulin therapy in managing acute stroke with hyperglycemia.
  • To highlight the potential impact of ongoing research, such as the SHINE study, on glycaemic control strategies.

Main Methods:

  • Review of existing literature on hyperglycemia and stroke.
  • Analysis of current treatment debates regarding insulin therapy in acute stroke.
  • Mention of ongoing clinical trials investigating intensive glucose control.

Main Results:

  • No current evidence supports the routine use of intravenous insulin for improving stroke outcomes.
  • Hyperglycemia in acute stroke is a significant indicator of a poor prognosis.
  • The efficacy of intensive glycaemic control in acute stroke requires further investigation.

Conclusions:

  • The management of hyperglycemia in acute stroke remains an area of active research and clinical debate.
  • Patients experiencing a stroke should be evaluated for underlying diabetes.
  • Future studies are crucial for establishing optimal glucose management protocols in acute stroke settings.

Keywords:
Acute StrokeDiabetesDiagnosisDiagnósticoHiperglucemiaHyperglycaemiaIctus agudoInsulinInsulinaTratamientoTreatment

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