Introduction
Glycemic variability (GV) represents the amplitude of oscillations in glucose levels over time and is associated with higher mortality in critically ill patients. Our aim is to evaluate the impact of GV on acute ischemic stroke (IS) outcomes in humans and explore the impact of two different insulin administration routes on GV in an animal model.
Methods
This translational study consists of two studies conducted in parallel: The first study is an observational, multicenter, prospective clinical study in which 340 patients with acute IS will be subcutaneously implanted a sensor to continuously monitor blood glucose levels for 96 h. The second study is a basic experimental study using an animal model (rats) with permanent occlusion of the middle cerebral artery and induced hyperglycemia (through an intraperitoneal injection of nicotinamide and streptozotocin). The animal study will include the following 6 groups (10 animals per group): sham; hyperglycemia without IS; IS without hyperglycemia; IS and hyperglycemia without treatment; IS and hyperglycemia and intravenous insulin; and IS and hyperglycemia and subcutaneous insulin. The endpoint for the first study is mortality at 3 months, while the endpoints for the animal model study are GV, functional recovery and biomarkers.
Discussion
The GLIAS-III study will be the first translational approach analyzing the prognostic influence of GV, evaluated by the use of subcutaneous glucose monitors, in acute stroke.
Trial registrationhttps://www.clinicaltrials.gov (NCT04001049)
En ocasiones se diagnostica como diabetes mellitus tipo 2 (DM2) a pacientes con diabetes mellitus tipo 1 (DM1), especialmente en sujetos obesos sin cetoacidosis diabética (CAD). Esto puede ser grave, entre otras cosas, debido a que los inhibidores del transportador sodio-glucosa tipo 2 empleados en DM2 se asocian a CAD euglucémica. Presentamos el caso de un varón de 42 años con DM2 de 13 años de evolución, que presentó CAD severa por dapagliflozina, así como un cuadro de cetosis severa intrahospitalaria por omisión de dosis subcutánea de insulina. Finalmente, se realizó el diagnóstico de DM1.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.