Hyperglycemia, recognized and unrecognized, as a risk factor for stroke and transient ischemic attacks

Area of Science:

• Endocrinology
• Neurology
• Clinical Chemistry

Background:

• Glycosylated hemoglobin (GHb) reflects long-term glycemic control.
• Stroke and transient ischemic attacks (TIA) are significant cerebrovascular events.

Purpose of the Study:

• To investigate the prevalence of elevated GHb in patients hospitalized for stroke or TIA.
• To assess the relationship between hyperglycemia and cerebrovascular disease.

Main Methods:

• GHb levels were measured in 50 patients with recent stroke/TIA.
• GHb values were compared to hospital controls without cerebrovascular disease and ambulatory diabetic patients.
• Patient history of diabetes or abnormal glucose tolerance was recorded.

Main Results:

• Stroke/TIA patients had significantly higher GHb levels (10.2% +/- 2.3) compared to controls (8.3% +/- 0.9).
• 42% of stroke/TIA patients (21/50) had undiagnosed hyperglycemia (GHb > 10%).
• Elevated GHb was not correlated with age, sex, smoking, hypercholesterolemia, or hypertension.

Conclusions:

• Hyperglycemia is a common, often unrecognized, precursor to stroke and TIA.
• Elevated GHb suggests that hyperglycemia is an under-appreciated risk factor for cerebrovascular disease.
• Screening for hyperglycemia should be considered in patients presenting with stroke or TIA.