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Reactive hyperglycaemia in patients with acute stroke

E Melamed

    Journal of the Neurological Sciences
    |October 1, 1976
    PubMed
    Summary

    Acute stroke can cause temporary high blood sugar (hyperglycaemia) in patients, even those without diabetes. This response is linked to stroke severity and type, impacting patient outcomes.

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    Area of Science:

    • Neurology
    • Endocrinology
    • Metabolic Disorders

    Background:

    • Acute stroke can trigger significant physiological changes.
    • The relationship between cerebrovascular events and glucose metabolism requires further elucidation.
    • Reactive hyperglycaemia in non-diabetic stroke patients is not fully understood.

    Purpose of the Study:

    • To investigate the incidence and characteristics of reactive hyperglycaemia following acute stroke.
    • To explore the association between hyperglycaemic responses and stroke type, location, and severity.
    • To examine the impact of reactive hyperglycaemia on patient outcomes, including mortality.

    Main Methods:

    • Retrospective analysis of 392 hospitalized patients with acute stroke.
    • Evaluation of initial and follow-up fasting serum glucose levels.
    • Correlation of hyperglycaemic responses with stroke characteristics and clinical status.

    Main Results:

    • 28% of non-diabetic patients exhibited transitory reactive hyperglycaemia.
    • Higher frequency and severity of hyperglycaemia were observed in haemorrhagic stroke and brainstem infarction.
    • Reactive hyperglycaemia correlated with stroke severity, coma, and significantly higher hospital mortality.
    • Patients with pre-existing diabetes also showed increased hyperglycaemic reactions.

    Conclusions:

    • Acute stroke can induce reactive hyperglycaemia through various mechanisms, including stress response and hypothalamic dysfunction.
    • Reactive hyperglycaemia is associated with poorer outcomes in acute stroke patients.
    • Stroke may unmask latent diabetes or exacerbate existing diabetic conditions.

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