Glucose tolerance following strokes in the elderly.

Area of Science:

• Geriatric Medicine
• Neurology
• Endocrinology

Background:

• Thrombotic stroke affects elderly individuals, often with undiagnosed metabolic conditions.
• Glucose intolerance following stroke is common, but its nature (transient vs. persistent) is debated.

Purpose of the Study:

• To determine if abnormal glucose tolerance post-stroke in the elderly is a persistent condition (true diabetes) or a temporary 'functional' state.
• To assess glucose tolerance changes in elderly stroke patients over a 12-week period.

Main Methods:

• 16 elderly patients (65-84 years) with thrombotic stroke underwent two standard 75g oral glucose tolerance tests (OGTT).
• Tests were conducted within one week and at 12 weeks post-stroke.
• Plasma glucose levels were analyzed for both tests.

Main Results:

• No significant difference in plasma glucose values was observed between the early and 12-week OGTTs.
• Six patients met criteria for diabetes mellitus based on both tests.
• The remaining ten patients showed no worsening of glucose tolerance, indicating stability.

Conclusions:

• Abnormal glucose tolerance detected soon after a stroke in the elderly is indicative of true diabetes mellitus.
• The findings suggest that 'functional diabetes' is unlikely to explain post-stroke glucose intolerance in this population.
• Early identification of diabetes post-stroke is crucial for appropriate management in elderly patients.