Study reveals high blood sugar at stroke admission linked to poor prognosis

The study published in the journal Cardiovascular Diabetology states that Having higher than usual blood sugar levels at the time of hospital admission for an ischemic stroke significantly increases the risk of a poor functional prognosis or death within three months of the stroke. This is the main conclusion of a study by the Endocrinology and Nutrition Services and the Neurology Department of Hospital del Mar, with researchers from the hospital's Research Institute, the RICORS-ICTUS network, and the CIBER of Diabetes and Associated Metabolic Diseases (CIBERDEM).

Inflammatory states in certain diseases can cause increased blood sugar levels, or hyperglycemia, which can influence prognosis. In ischemic stroke, elevated blood sugar levels are common but have not been thoroughly analyzed. The Hospital del Mar study addresses this issue by reviewing data from 2,774 patients with ischemic stroke. The study considers blood sugar levels at the time of admission and compares them with each patient's usual levels. Additionally, variables such as age, diabetes, disability, stroke severity, and treatment received were taken into account.

The study confirmed that elevated blood glucose levels at stroke admission are associated with worse functional outcomes and increased mortality three months post-stroke, independent of other factors. Even a modest 13% increase above usual glucose levels significantly worsens prognosis, regardless of baseline glucose levels. This association was also observed in patients with a history of diabetes, who comprised 35% of the study population.

The study concluded that elevated blood sugar levels at the time of stroke admission are associated with a poorer prognosis. Higher admission glucose levels correlate with an increased risk of adverse outcomes, including greater neurological impairment and reduced functional recovery. These findings have highlighted the importance of managing blood sugar levels promptly and effectively in stroke patients to improve overall outcomes and reduce long-term complications. Enhanced glycemic control during the acute phase of stroke may be crucial for optimising patient recovery and minimising disability.

References: Climent, E., et al. (2024). Acute-to-chronic glycemic ratio as an outcome predictor in ischemic stroke in patients with and without diabetes mellitus. Cardiovascular Diabetology. doi.org/10.1186/s12933-024-02260-9.