Managing post stroke hyperglycaemia: moderate glycaemic control is better? An update

Wan Sulaiman, Wan Aliaa and Hashim, Hasnur Zaman and Che Abdullah, Shahrin Tarmizi and Fan, Kee Hoo and Basri, Hamidon (2014) Managing post stroke hyperglycaemia: moderate glycaemic control is better? An update. EXCLI Journal, 13. pp. 825-833. ISSN 1611-2156

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Abstract

Post stroke hyperglycaemia (PSH) is prevalent in (AIS) acute ischaemic stroke patients and it has been associated with a dismal outcome of death and disability. Insulin has been proven to attenuate glucose effectively in stroke patients, thus many trials over the years had studied the efficacy of intensive treatment aiming at normalization of blood sugar level in order to im-prove the bleak outcomes of PSH. However, tight glycaemic control failed to be translated in-to clinical benefits and the outcomes are no different from the conventional approach, despite the costly healthcare expenditure invested. On the contrary, it brings more significant harm than the intended benefit, as 1 in every 9 treated patients had symptomatic hypoglycaemia. Thus, the benefits of tight glucose control, if any, are overshadowed by this potential risk of hypoglycaemia causing permanent neurological injury. Therefore, international practice guidelines recommend for less aggressive treatment to maintain blood glucose level within an appropriate range in AIS patients. However, there are limited details for stroke-specific gly-caemic management and this made management of PSH particularly difficult. This review is to discuss and provide suggestions concerning glycaemic control in acute ischaemic stroke; the direction of its future prospective clinical trials and the treatment strategy required based on recent literature.

Item Type:	Article (Journal)
Additional Information:	5220/37841
Uncontrolled Keywords:	Acute ischaemic stroke, hyperglycaemia, glycaemic control, insulin
Subjects:	R Medicine > R Medicine (General) R Medicine > RC Internal medicine > RC321 Neuroscience. Biological psychiatry. Neuropsychiatry
Kulliyyahs/Centres/Divisions/Institutes (Can select more than one option. Press CONTROL button):	Kulliyyah of Medicine > Department of Internal Medicine
Depositing User:	Dr Hasnur Zaman Hashim
Date Deposited:	20 Aug 2014 12:30
Last Modified:	20 Sep 2017 15:50
URI:	http://irep.iium.edu.my/id/eprint/37841

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