The prognostic value of stress hyperglycaemia and previously unrecognized diabetes in acute stroke

• Published in: Diabetic medicine Vol. 4; no. 3; p. 237
• Main Authors: Gray, C S, Taylor, R, French, J M, Alberti, K G, Venables, G S, James, O F, Shaw, D A, Cartlidge, N E, Bates, D
• Format: Journal Article
• Language: English
• Published: England 06-05-1987
• Subjects: Adult; Aged; Cerebrovascular Disorders - etiology; Cerebrovascular Disorders - mortality; Diabetes Mellitus, Type 2 - complications; Diabetic Angiopathies - etiology; Female; Humans; Hyperglycemia - complications; Male; Middle Aged; Prognosis; Risk; Stress, Physiological - complications
• ISSN: 0742-3071
• DOI: 10.1111/j.1464-5491.1987.tb00870.x

In a prospective study of 86 patients with acute stroke, blood glucose and HbA1 were estimated within 72 h of onset. The prevalence of previously diagnosed diabetes mellitus was 8% whereas 28% could be assumed to have had unrecognized hyperglycaemia preceeding the acute event as identified by a stable HbA1 raised more than two SD above the mean reference value. Complete functional recovery of the limbs within 4 weeks of the stroke was confined to those patients with a normal admission blood glucose. None of the patients with a raised admission blood glucose regained full functional recovery within 4 weeks. Cumulative mortality at 4 weeks was significantly raised in patients with an elevated blood glucose value irrespective of their HbA1 values (p less than 0.05). The prevalence of unrecognized hyperglycaemia as a risk factor for acute stroke is greater than previously reported in the UK and admission blood glucose concentration is of greatest importance in predicting early mortality and morbidity.