American researchers have recently examined the question of whether intensive glucose control improves functional outcome amongst people with hyperglycaemia after acute ischemic stroke. This was a randomised clinical trial included of 1151 adults (mean age 66 years) with hyperglycemia (glucose concentration of >110 mg/dL with diabetes or ≥150 mg/dL without diabetes). Subjects either received continuous intravenous insulin (target blood glucose concentration of 80-130 mg/dL [4.4-7.2 mmol/L]; intensive treatment group: n = 581) or SC insulin on a sliding scale (target blood glucose concentration of 80-179 mg/dL [4.4-9.9 mmol/L]; standard treatment group: n = 570) for up to 72 hours. The mean blood glucose level was 118 mg/dL (6.6 mmol/L) in the intensive treatment group and 179 mg/dL (9.9 mmol/L) in the standard treatment group. Favorable outcomes were seen in 119 of 581 patients (20.5%) in the intensive treatment group and in 123 of 570 patients (21.6%) in the standard treatment group. Treatment was stopped early for hypoglycemia or other adverse events in 65 of 581 patients (11.2%) in the intensive treatment group and in 18 of 570 patients (3.2%) in the standard treatment group. Severe hypoglycemia occurred only among patients in the intensive treatment group (15/581 [2.6%]). The conclusion was that intensive glucose control in this setting is probably not worth pursuing. Read the original research here.
Intensive BGL control probably not warranted after stroke
Jul 25, 2019