A Study on the Relationship of Glycaemic Status with Nature of Lesions in Acute Stroke Patients

Abstract

Background: Stroke in patients of Diabetes Mellitus is a common complication all over the world. The present study was done with the aim to assess the blood glucose level in acute stroke patients of Manipur and find out any correlation with types, size and prognosis of different glycaemic group. Method: The study was a prospective cross-sectional study of all patients who were admitted as acute stroke in Medicine ward, Jawaharlal Nehru Institute of Medical Sciences (JNIMS), Imphal, Manipur. Clinical parameter including History and clinical examination findings were recorded. CT scan of brain, blood glucose level, HbA1c were taken in all the patients. Results: Of 109 patients of acute stroke patients included in the study, 34 were known cases of Diabetes, 10 were newly detected Diabetes cases summing up to a total of 64 cases of Diabetes, 44 of the cases had stress hyperglycaemia and 21 were euglycaemic. Maximum cases consisted of ischaemic strokes (84.4%) and maximum number of haemorrhagic strokes falls under the known diabetes group.None of the euglycaemic patients had any large sized lesions, maximum of them (89.5%) had small sized lesions. Most of the stress glycaemia patients had medium sized strokes while the known diabetes and newly detected diabetes groups had no case of small sized lesion with the maximum large sized lesions occurring in the known diabetes group (78.9%). Clinical outcome was worst in poor glucose control group with 70.3% fatality in this group while maximum clinical improvement was seen in Non-Diabetics (84.6%) consisting of euglycaemia and stress hyperglycaemia groups. Conclusion: There was a good correlation with admission day hyperglycaemia with the size of the stroke lesion in all cases of stroke. The diabetes especially poor glucose control group is associated with increased size of the stroke lesion, severity and poor clinical outcome. Keywords: Stroke, diabetes mellitus, stress hyperglycaemia, euglycaemia.