Poor Stroke Outcomes Could Be Signaled By Glucose Levels

High glucose levels following acute ischemic stroke (AIS) or intracerebral hemorrhage (ICH) are associated with poor outcomes at 3 months, according to a recent study.

Findings were presented at the International Stroke Conference, which is taking place from January 24-26, 2018, in Los Angeles, California.
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In the COMPLEAT Study, the researchers evaluated 100 patients with AIS (n = 58) or ICH (n = 42). A continuous glucose monitoring (CGM) device was attached to each patient for the first 72 hours following emergent admission.

The CGM device collected 7 glucose barometers, including maximum, minimum, an area under the curve of more than 8 mmol/L blood glucose (8AUC), and a distribution time of more than 8 mmol/L blood glucose (8time-ratio).

Patients’ mean glucose levels ranged from 6.2 mmol/L to 11.4 mmol/L within 72 hours, with an 8AUC of 0.7 minхmmol/L and an 8time-ratio of 31.7%. Overall, hypoglycemia occurred in 15% of patients.

Ultimately, mean glucose levels (adjusted odds ratio [OR] 1.59), 8AUC (2.06) and 8time-ratio (OR 1.25) were found to associated with unfavorable outcomes, both overall and in patients with AIS. Additionally, 8time-ratio was found to be associated with neurological deterioration overall (adjusted OR 1.49).

“High mean glucose levels, 8time-ratio [levels], and 8AUC levels were associated with unfavorable outcomes at 3 months,” the researchers concluded. “High 8time-ratio levels were related to early neurological deterioration within 7 days.”

—Christina Vogt

Reference:

Wada S, Yoshimura S, Inoue M, e al. Outcome prediction in acute stroke patients by continuous glucose monitoring: Continuous glucose Monitoring for acute stroke Patients receiving Latest treatment (COMPLEAT) Study. Paper presented at: International Stroke Conference; January 24-26, 2018; Los Angeles, CA. http://stroke.ahajournals.org/content/49/Suppl_1/A7.