Saratov JOURNAL of Medical and Scientific Research

Clinical significance of hyperglycemia in acute ischemic stroke

Year: 2018, volume 14 Issue: №2 Pages: 220-225
Heading: Neurology Article type: Original article
Authors: Izhbuldina G.l., Novikova L.B.
Organization: Bashkir State Medical University of the Russian Health Care, Ufa Clinical Hospital №18
Summary:

Aim: to study the effect of hyperglycemia on the course and clinical outcome of ischemic stroke (IS) in the acute period. Material and Methods. A total of 862 patients with IS (370 men, 492 women), mean age was 66.1±10.8 years. The degree of neurological deficit (NIHSS scale) and functional disorders (Rankin scale), clinical outcome were assessed. When admitted to hospital, a study of the level of glycemia on an empty stomach was conducted. Results. In 186 (21.6%) patients type 2 diabetes Mellitus (DM) was diagnosed. In 27.8% of patients without DM and 76.3% of patients with DM hyperglycemia was detected. In patients without DM with hyperglycemia, higher than in patients with normoglycemia, the representation of women (by 9.9%), cardioembolic stroke (by 10.5%), severe neurological deficit (by 14.7%), gross impairment of vital activity (by 14.0%), a decrease in the frequency of noticeable positive dynamics (by 14.8%), an increase in mortality (by 11.5%). In patients with DM, hyperglycemia was associated with a higher assessment rate on the Rankin scale of 4-5 points (by 25.6%) and a decrease in the incidence of noticeable positive dynamics (by 27.7%). Conclusion. Development of IS is characterized by high representation of disorders of carbohydrate metabolism (21,6%). The severity of glucose metabolism disorders is interrelated with the severity and clinical outcome of the disease.

Bibliography:
1. Bejot Y, Bailly H, Durier J, Giroud M. Epidemiology of stroke in Europe and trends for the 21st century. Presse Med 2016; 45 (12): e391-e398. DOI: 10.1016/j.lpm.2016.10.003
2. Gusev El, Skvorcova VI, Martynov MJu, Kamchatov PR. Cerebral stroke: problems and solutions. Bulletin of RSMU 2006; 51 (4): 28-32
3. Dedov II, Shestakova MV Cerebral vascular lesions in diabetes mellitus: solved and unresolved questions. Zhurnal nevrologii i psikhiatrii imeni S. S. Korsakova 2015; 8: 79-82
4. Bruno A, Leibeskind D, Нао Q, Raychev R. Diabetes mellitus, acute hyperglycemia, and ischemic stroke. Cur Treat Opt in Neurology 2010; 12: 492-503. DOI: 10.1007/ s11940-010-0093-6
5. Badiger Sh, Akkasaligar PT, Narone U. Hyperglycemia and Stroke. Int J Stroke Res 2013; 1:1-6
6. Clark ME, Payton JE, Pittiglio LI. Acute Ischemic Stroke and Hyperglycemia. Critical Care Nursing Quarterly 2014; 37: 182-187
7. Liang J, Liu W1, Sun J, Gu X, Ma Q, Tong W. Analysis of the risk factors for the short-term prognosis of acute ischemic stroke. IntJClin Exp Med 2015; 8 (11): 21915-24
8. M. Yao, J. Ni, L. Zhou, B. Peng, Yg Zhu, L. Cui, SMART investigators. Elevated Fasting Blood Glucose Is Predictive of Poor Outcome in Non-Diabetic Stroke Patients: A Sub-Group Analysis of SMART. PLoS One 2016; 11 (8): e0160674. DOI: 10.1371/journal.pone.0160674
9. Nasledov AD. SPSS 19: Professional statistical analysis of data. St. Petersburg: Piter, 2011; 400 p.
10. Dedov II, Shestakova MV, MajorovAJu, et al. Algorithms of specialized medical care for patients with diabetes. Diabetes Mellitus 2017; 20 (1S): 1-112. DOI: 10.14341/DM20171S8
11. American Diabetes Association. Classification and Diagnosis of Diabetes. Diabetes Care 2017; 40 (1): S11-S24. DOI.org/10.2337/dc17-S005
12. Bilotta F, Rosa G. Glycemia management in critical care patients. World journal of diabetes 2012; 3 (7): 130-134. DOI: 10.4239/wjd.v3.i7.130
13. Suntsov Yl, Bolotskaya LL, Maslova OV, Kazakov IV Epidemiology of diabetes mellitus and prognosis of its prevalence in the Russian Federation. Diabetes mellitus 2011; 14(1): 15-19
14. Trunova ES, Fonakin AV, Geraskina LA, Samokhvalova EV Heart condition and the acute period of ischemic stroke. Clinical pharmacology and therapy 2007; (5): 55-58
15. Huang Y, Cai X, Mai W, Li M, Hu Y. Association between prediabetes and risk of cardiovascular disease and all cause mortality: systematic review and meta-analysis. BMJ 2016; 355: i5953. DOI: 10.1136/bmj.i5953.

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