Endocrine Abstracts

Introduction: Hyperglycemia is common in acute ischemic stroke and is associated with worse neurological outcomes. This study aims explore the association between hyperglycemia and short-term stroke outcomes.

Methods: We retrospectively reviewed the records of 97 consecutive patients with acute ischemic stroke managed in a cardiovascular hospital. Hyperglycemia was defined as RBG > 7.8 mmol/l on admission, and was considered sustained if it persisted beyond 24 hours. HbA1c was done in patients with diabetes or hyperglycemia An NIHSS score >10 was classified as severe stroke and modified Rankin Scale (mRS) score > 2 as stroke-disability. Seventh-day neurological improvement (SDNI) was defined as a ≥ 2-point improvement in NIHSS score by day-7. The association between diabetes status, hyperglycemia, HbA1c and the stroke severity, disability, improvement and 30-day mortality was analyzed.

Results: Insulin was required in 29 patients, most commonly basal + supplemental insulin regimen. Patients with diabetes were more likely to have significant stroke-disability (Or=2.54 CI 1.07 – 6.04), but it was not significantly associated with stroke severity, SDNI or 30-day mortality. Patients with admission hyperglycemia had a trend for high-mortality (Or=3.05, CI = 0.99 – 9.5), but was only significant amongst patients with sustained hyperglycemia (Or=4.78, CI = 1.46 – 15.68). Hyperglycemia was not significantly associated with the other stroke indices. HbA1c level was not associated with stroke severity, disability, improvement or mortality.

Conclusion: Poor neurological outcomes are common amongst stroke patients with diabetes. Hyperglycemia portends a high-risk, especially when sustained while HbA1c does not have any apparent short-term prognostic implications.