Related Experiment Video
Updated: Oct 11, 2025
A Mouse Model of Hemorrhagic Transformation Induced by Acute Hyperglycemia Combined with Transient Focal Ischemia
Published on: November 15, 2024
Effect of Moderate and Severe Persistent Hyperglycemia on Outcomes in Patients With Intracerebral Hemorrhage
Adnan I Qureshi1,2, Wei Huang2, Iryna Lobanova2
1Zeenat Qureshi Stroke Institute, St Cloud, MN (A.I.Q., W.H., I.L.).
Insights
Persistent hyperglycemia increases death or disability risk in nondiabetic patients after intracerebral hemorrhage. This finding highlights the importance of glucose management in stroke recovery for this patient group.
Area of Science:
- Neurology
- Endocrinology
- Critical Care Medicine
Background:
- Intracerebral hemorrhage (ICH) is a severe neurological condition.
- Hyperglycemia is a common complication following acute stroke.
- The impact of persistent hyperglycemia on ICH outcomes requires further elucidation.
Purpose of the Study:
- To investigate the association between persistent hyperglycemia and 90-day death or disability in patients with ICH.
- To analyze these associations in subgroups with and without pre-existing diabetes.
Main Methods:
- A cohort of 1000 ICH patients were enrolled within 4.5 hours of symptom onset.
- Hyperglycemia was categorized as moderate (140-179 mg/dL) or severe (≥180 mg/dL) based on serum glucose levels measured over 72 hours.
- Persistent hyperglycemia was defined as two consecutive elevated glucose measurements 24 hours apart.
Main Results:
- Both moderate and severe persistent hyperglycemia were significantly associated with increased 90-day death or disability in the overall ICH cohort.
- In patients without pre-existing diabetes, moderate and severe hyperglycemia independently increased the risk of death or disability.
- No significant association was found between hyperglycemia and adverse outcomes in patients with pre-existing diabetes.
Conclusions:
- Persistent hyperglycemia is an independent risk factor for poor outcomes in nondiabetic patients following intracerebral hemorrhage.
- These findings underscore the need for vigilant glucose monitoring and management in non-diabetic ICH patients.
- Further research may explore targeted glycemic interventions to improve outcomes in this population.
Background:
We evaluated the effect of persistent hyperglycemia on outcomes in 1000 patients with intracerebral hemorrhage enrolled within 4.5 hours of symptom onset.
Methods:
We defined moderate and severe hyperglycemia based on serum glucose levels ≥140 mg/dL-<180 and ≥180 mg/dL, respectively, measured at baseline, 24, 48, and 72 hours. Persistent hyperglycemia was defined by 2 consecutive (24 hours apart) serum glucose levels. We evaluated the relationship between moderate and severe hyperglycemia and death or disability (defined by modified Rankin Scale score of 4-6) at 90 days in the overall cohort and in groups defined by preexisting diabetes.
Results:
In the multivariate analysis, both moderate (odds ratio, 1.8 [95% CI, 1.1-2.8]) and severe (odds ratio, 1.8 [95% CI, 1.2-2.7]) hyperglycemia were associated with higher 90-day death or disability after adjusting for Glasgow Coma Scale score, hematoma volume, presence or absence of intraventricular hemorrhage, hyperlipidemia, cigarette smoking, and hypertension (no interaction between hyperglycemia and preexisting diabetes, P=0.996). Among the patients without preexisting diabetes, both moderate (odds ratio, 1.8 [95% CI, 1.0-3.2]) and severe (odds ratio, 2.0 [95% CI, 1.1-3.7]) hyperglycemia were associated with 90-day death or disability after adjusting for above mentioned potential confounders. Among the patients with preexisting diabetes, moderate and severe hyperglycemia were not associated with 90-day death or disability.
Conclusions:
Persistent hyperglycemia, either moderate or severe, increased the risk of death or disability in nondiabetic patients with intracerebral hemorrhage.
Registration:
URL: https://www.
Clinicaltrials:
gov; Unique identifier: NCT01176565.
Related Concept Videos
01:15Hypoglycemia and Glucagon
01:15Diabetes: Symptoms, Diagnosis, and Complications
01:15Diabetes: Management and Pharmacotherapy
Insulin remains the cornerstone of treatment for most patients with type 1 and many...
01:22Diabetes Mellitus: Overview and Type I Subtype
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body is unable to produce sufficient insulin, and individuals with...
01:30Acute Pancreatitis II: Clinical Manifestations and Management