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Blood Glucose Levels and Stroke Severity in Patients with Acute Small Subcortical Infarct
Stefano Mombelli1, Chiara Rinaldi2, Andrea Morotti3
1Neurofarba Department, University of Florence, Careggi University Hospital, 50134 Florence, Italy.
Brain Sciences
|December 24, 2025
Summary
Higher blood glucose levels in patients with acute small subcortical infarct (SSI) correlate with increased stroke severity. This association was observed at both admission and discharge, suggesting a link between glucose and SSI severity.
Area of Science:
- Neurology
- Endocrinology
- Clinical Medicine
Background:
- Hyperglycemia is frequently observed in acute ischemic stroke patients, often linked to adverse outcomes.
- The precise relationship between blood glucose levels and stroke severity, particularly in acute small subcortical infarct (SSI), remains incompletely understood.
- Understanding this link is crucial for managing stroke patients and potentially improving prognoses.
Purpose of the Study:
- To investigate the association between blood glucose levels and stroke severity in patients presenting with acute small subcortical infarct (SSI).
- To determine if elevated blood glucose levels predict greater stroke severity at presentation and discharge.
- To explore potential biological connections between glucose regulation and the extent of small subcortical infarcts.
Main Methods:
- A retrospective review of 792 patients with acute SSI admitted to six Stroke Units.
- Stroke severity was quantified using the National Institutes of Health Stroke Scale (NIHSS) at admission and discharge.
- Logistic and ordinal regression analyses were employed to assess independent associations between baseline glucose levels and NIHSS scores, adjusting for covariates.
Main Results:
- Patients with moderate-to-severe NIHSS scores exhibited significantly higher mean baseline blood glucose levels (148 mg/dL) compared to those with lower NIHSS scores (125 mg/dL).
- Elevated glucose levels (≥ 130 mg/dL) and the highest glucose quartile were independently associated with a higher likelihood of baseline NIHSS ≥ 7.
- Higher blood glucose levels were also significantly associated with increased stroke severity (higher NIHSS scores) at discharge.
Conclusions:
- In patients diagnosed with acute small subcortical infarct (SSI), elevated blood glucose levels are demonstrably linked to greater stroke severity.
- This association persists at both the time of admission and at discharge, indicating a consistent relationship.
- The findings suggest a potential biological mechanism connecting blood glucose dysregulation and the severity of small subcortical infarcts.
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