Source:http://linkedlifedata.com/resource/pubmed/id/20621520
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| Predicate | Object |
|---|---|
| rdf:type | |
| lifeskim:mentions | |
| pubmed:issue |
2
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| pubmed:dateCreated |
2011-2-21
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| pubmed:abstractText |
Several reports indicate that mild hyperglycemia (plasma glucose level [PGL] ?7.0 and ?10.0 mmol/L [?126 and ?180 mg/dL]) is associated with poor prognosis in nondiabetic patients who sustain acute ischemic stroke (AIS). Insulin therapy to maintain PGL <7.0 mmol/L (<126 mg/dL) has been reported to be beneficial in critically ill patients, but the safety and efficacy of this approach in patients with AIS are not well established. In a prospective, open-label study, 50 consecutive nondiabetic patients with AIS admitted within 12 hours of ictus and with a PGL ?7.0 and ?10.0 mmol/L (?126 and ?180 mg/dL) were randomized to receive either a 24-hour intravenous (IV) insulin infusion (ISI) adjusted to maintain PGL within 4.5-7.0 mmol/L (81-126 mg/dL) (ISI group; n=26) or treatment with subcutaneous insulin if PGL was >10.0 mmol/L (>180 mg/dL) (control group [CG]; n=24). Patients' neurologic status was assessed based on National Institutes of Health Stroke Scale (NIHSS) score at admission, 24 hours and 30 days. The 2 groups did not differ in terms of risk factors for stroke. The mean PGL measured at admission was 8.25±0.9 mmol/L (149±16 mg/dL) in the ISI group and 8.1±0.8 mmol/L (146±14 mg/dL) in the CG (P=.8). After 24 hours, these values dropped to 4.9±0.5 mmol/L (88±9 mg/dL) and 5.5±0.45 mmol/L (99±8 mg/dL), respectively (P < .01). Two patients from the ISI group (8%) required IV glucose infusion for symptomatic hypoglycemia. There was no significant between-group difference in neurologic status at admission (median NIHSS score, 10±3 vs 10±2) and 24 hours later (8±2 vs 9±3). At 30 days, the median NIHSS score was 4±3 in the ISI group and 7±4 in the CG (P=.04). Our findings indicate that in nondiabetic AIS patients with mild hyperglycemia, IV insulin therapy aimed at maintaining strict glycemic control (PGL 4.5-7.0 mmol/L [81-126 mg/dL]) is relatively safe and may improve stroke outcome.
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| pubmed:language |
eng
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| pubmed:journal | |
| pubmed:citationSubset |
IM
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| pubmed:chemical | |
| pubmed:status |
MEDLINE
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| pubmed:issn |
1532-8511
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| pubmed:author | |
| pubmed:copyrightInfo |
Copyright © 2011 National Stroke Association. Published by Elsevier Inc. All rights reserved.
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| pubmed:issnType |
Electronic
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| pubmed:volume |
20
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| pubmed:owner |
NLM
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| pubmed:authorsComplete |
Y
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| pubmed:pagination |
150-4
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| pubmed:dateRevised |
2011-11-17
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| pubmed:meshHeading |
pubmed-meshheading:20621520-Aged,
pubmed-meshheading:20621520-Aged, 80 and over,
pubmed-meshheading:20621520-Blood Glucose,
pubmed-meshheading:20621520-Chi-Square Distribution,
pubmed-meshheading:20621520-Disability Evaluation,
pubmed-meshheading:20621520-Female,
pubmed-meshheading:20621520-Humans,
pubmed-meshheading:20621520-Hyperglycemia,
pubmed-meshheading:20621520-Hypoglycemic Agents,
pubmed-meshheading:20621520-Infusions, Intravenous,
pubmed-meshheading:20621520-Injections, Subcutaneous,
pubmed-meshheading:20621520-Insulin,
pubmed-meshheading:20621520-Logistic Models,
pubmed-meshheading:20621520-Male,
pubmed-meshheading:20621520-Middle Aged,
pubmed-meshheading:20621520-Poland,
pubmed-meshheading:20621520-Prospective Studies,
pubmed-meshheading:20621520-Risk Assessment,
pubmed-meshheading:20621520-Risk Factors,
pubmed-meshheading:20621520-Severity of Illness Index,
pubmed-meshheading:20621520-Stroke,
pubmed-meshheading:20621520-Time Factors,
pubmed-meshheading:20621520-Treatment Outcome
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| pubmed:articleTitle |
Intravenous insulin therapy in the maintenance of strict glycemic control in nondiabetic acute stroke patients with mild hyperglycemia.
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| pubmed:affiliation |
Clinic of Neurology, Military Medical Institute, Warsaw, Poland. staszej@amwaw.edu.pl
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| pubmed:publicationType |
Journal Article,
Comparative Study,
Randomized Controlled Trial
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