Beyond hyperglycemia: glycaemic variability as a prognostic factor after acute ischemic stroke

Area of Science:

• Neurology
• Endocrinology
• Clinical Medicine

Background:

• Glycaemic variability (GV) involves fluctuations in blood glucose levels.
• GV may impact outcomes following a stroke.
• Understanding GV's role in acute ischaemic stroke is crucial.

Purpose of the Study:

• To assess the effect of glycaemic variability (GV) on acute ischaemic stroke progression.
• To determine the association between GV and stroke outcomes, including mortality and dependency.

Main Methods:

• Exploratory analysis of the prospective, observational GLIAS-II study.
• Capillary glucose measured every 4 hours for 48 hours post-stroke.
• GV defined as standard deviation of mean glucose; primary outcomes: mortality and death/dependency at 3 months.

Main Results:

• Higher GV observed in patients who died (30.9 mg/dL vs 23.3 mg/dL).
• GV (OR=1.03) and stroke severity (OR=1.12) independently associated with 3-month mortality.
• Subcutaneous insulin linked to higher GV than intravenous insulin (38.95 mg/dL vs 21.34 mg/dL).

Conclusions:

• Elevated GV in the first 48 hours post-ischaemic stroke independently predicts mortality.
• Route of insulin administration may influence GV levels.