Endocrine Abstracts

Introduction: Post-stroke hyperglycemia affects two-thirds of the patients during acute ischaemic stroke and it is associated with poorer outcomes. The aim of this study was to analyze the differences between the diabetic and non- diabetic patients that underwent an acute stroke.

Methods: Retrospective descriptive study of patients admitted to the Acute Stroke Unit from January to June 2017, including blood parameters, glycemic treatment and 3 months outcomes.

Results: From January to June 2017, 126 patients were admitted to the Acute Stroke Unit. 28,6% of them with a previous diagnosis of diabetes. More than half of the patients were men and the mean age was 73.2 (S.D. 9.0) in diabetics and 71.9 (S.D. 12.8) in non-diabetics. 17% (n=6) of the diabetic patients needed thrombolysis versus 11%(n=10) of non diabetics. Mean HbA1C was 7.4% (S.D. 1.4) in diabetics against 5.6% (S.D. 0.39) in non-diabetics. Mean glucose level in diabetics at admission was 166.0 mg/dl (S.D. 67.6) and in the first 72 hours 159.2 mg/dl (S.D. 51.5) starting treatment with an average of 185.0 mg/dl (S.D. 53.6). The most common treatment used was IV insulin 41.7% (n=15), sliding-scale SC insulin 19.4% (n=7), sliding-scale with basal SC insulin 14% (n=5) and only one patient received metformin on the acute treatment. 22.2% (n=8) of the diabetic patients had no treatment during admission. In non-diabetic patients, the mean glucose level at admission was 108.0 mg/dl (S.D. 19.8) and in the first 72 hours 104.4 mg/dl (S.D. 16.0). Only one of them developed stress hyperglycemia and was treated with sliding-scale SC insulin. Regarding outcomes, 41.7% of diabetics had a total recovery, 50% developed sequels and 8.3% died versus 51.1%, 45.6%, 3.3% in non-diabetics. 16.7% of the diabetics were readmitted in less than 3 months versus 12% of the non-diabetics, not statistically significant. The outcomes were related with the glucose level when treatment was started, 173.5 mg/dl (S.D. 57.4) in those with a total recovery, 189.4 mg/dl (S.D. 50.9) the ones that developed sequels and 202.0 (S.D. 32.6) in those that died during the admission, although the differences were not statistically significant.

Conclusions: Diabetic patients seemed to have poorer outcomes after a stroke. The poorest outcomes seemed to be related to the highest glucose level when treatment was started, although our sample was not large enough to detect significant differences. Almost 20% of diabetics received sliding-scale SC insulin although studies had shown is not an appropriate treatment.