Natural history of blood glucose within the first 48 hours after ischemic stroke

Wong, A. A., Schluter, P. J., Henderson, R. D., O'Sullivan, J. D. and Read, S. J. (2008) Natural history of blood glucose within the first 48 hours after ischemic stroke. Neurology, 70 13: 1036-1041. doi:10.1212/01.wnl.0000306635.08410.68


Author Wong, A. A.
Schluter, P. J.
Henderson, R. D.
O'Sullivan, J. D.
Read, S. J.
Title Natural history of blood glucose within the first 48 hours after ischemic stroke
Journal name Neurology   Check publisher's open access policy
ISSN 0028-3878
Publication date 2008-03-01
Year available 2008
Sub-type Article (original research)
DOI 10.1212/01.wnl.0000306635.08410.68
Open Access Status Not yet assessed
Volume 70
Issue 13
Start page 1036
End page 1041
Total pages 6
Place of publication United States
Publisher Lippincott William & Wilkins
Language eng
Subject C1
920210 Nursing
111099 Nursing not elsewhere classified
920103 Cardiovascular System and Diseases
920104 Diabetes
110201 Cardiology (incl. Cardiovascular Diseases)
Abstract Background: Despite suggestions that glucose levels rise after stroke before falling within a few hours, the natural history and determinants of this phenomenon remain unclear. We aimed to better characterize the time course of changes in glucose levels after ischemic stroke and to identify factors that affect poststroke glycemia.
Formatted abstract
Background: Despite suggestions that glucose levels rise after stroke before falling within a few hours, the natural history and determinants of this phenomenon remain unclear. We aimed to better characterize the time course of changes in glucose levels after ischemic stroke and to identify factors that affect poststroke glycemia.

Methods: Patients with ischemic stroke without previously diagnosed diabetes had blood glucose measured at least 4-hourly until 48 hours poststroke. The relationship between baseline factors, such as the NIH Stroke Scale, and blood glucose was assessed with mixed-effects models. The behavior of glucose over time was modeled in the whole cohort, and for the cohort partitioned into two around an admission glucose of 6.0 mmol/L.

Results: In the cohort of 124 patients the mean glucose was 6.6 mmol/L throughout the period of monitoring, with no change over time. Mixed-effects models identified more severe stroke and glucose-lowering therapy to be associated with higher poststroke glucose levels. When the cohort was partitioned, the mean glucose of those below 6.0 mmol/L at admission increased and the mean glucose of those above 6.0 mmol/L at admission decreased to the overall mean.

Conclusions: Mean glucose levels remain static in patients with ischemic stroke without diabetes until at least 48 hours poststroke. Serial glucose levels are higher in patients with more severe stroke. Initially high or low mean glucose recordings exhibit regression to the mean over time, a change which may merely be a statistical phenomenon without necessarily indicating resolution of abnormal glycemia.

Keyword blood glucose
Ischemic Stroke
Q-Index Code C1
Q-Index Status Confirmed Code
Grant ID F32HL09328-02
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: 2009 Higher Education Research Data Collection
School of Nursing, Midwifery and Social Work Publications
 
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Created: Mon, 30 Mar 2009, 00:34:47 EST by Vicki Percival on behalf of School of Nursing, Midwifery and Social Work