Admission Hyperglycemia is a Poor Prognostic Sign in Both Diabetics and Non-Diabetics

Akbar, Daad; Ahmed, Motaheruddin; Alghamdi, Nawal; Hijazi, N; Alshaikh, Abdulrahman

doi:10.4197/med.12-1.6

Cited by 4 publications

(11 citation statements)

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“…Akbar DH et al showed predominance in male among the diabetic and nondiabetic stroke patients and female predominance among the new hyperglycemic stroke patients. 6 Umpierrez et al on the other hand showed a female predominance among all his groups. 10 In the present study we noticed that the diabetic group (group 3) had a higher level of BMI which was similar to the study done by Akbar DH et al and Umpierrez et al 6,10 In the present study, hypertension was the common comorbidity associated with stroke and the numbers were significantly higher in group 3.…”

Section: Discussionmentioning

confidence: 81%

“…6 Umpierrez et al on the other hand showed a female predominance among all his groups. 10 In the present study we noticed that the diabetic group (group 3) had a higher level of BMI which was similar to the study done by Akbar DH et al and Umpierrez et al 6,10 In the present study, hypertension was the common comorbidity associated with stroke and the numbers were significantly higher in group 3. Tanmoy WM et al in his study showed an equal number of hypertension between the diabetic and non-diabetic strokes group.…”

Section: Discussionmentioning

confidence: 81%

“…In the present study, the stroke onset was at an earlier age with group 3, followed by group 2 and group 1.Akbar DH et al in his study observed a lower average age among the new hyperglycemic groups as compared to the non diabetic and diabetic groups which was proven to be statistically significant with p value of < 0.001. 6 They also observed a lower average age of 56.9±8. In the present study, predominantly male patients were affected in all the 3 groups.…”

Section: Discussionmentioning

confidence: 91%

“…Various clinical and experimental studies have shown that admission hyperglycemia has an adverse effect on the neurological and short term outcomes in ischemic stroke. [3][4][5][6] This acute hyperglycemia in stroke is not always due to type 2 diabetes mellitus, but instead may be due to stress response mediated partly by release of cortisol and norepinephrine. 7 Stress hyperglycemia generally refers to a transient hyperglycemia during illnesses and restricted to individuals without prior evidence of DM.…”

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confidence: 99%

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A study of stress hyperglycemia and its relationship with the neurological outcome in patients presenting with acute ischemic stroke

et al. 2016

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Stroke is a common cause of emergency admission which is associated with increased mortality, morbidity and poor quality of life. After coronary artery disease and cancer, stroke is the 3rd most common cause of death in elderly. 1 The outcome of stroke is influenced by various factors including severity, type of stroke, predisposing factors, ABSTRACT Background: Cerebrovascular accident (CVA) continues to be the most common neurological disease in the developed and developing countries. It also stands as the 3rd more common cause of death after cardiovascular disease and cancer. Stroke related burden keeps rising among the patients, their relatives and treating consultants. The neurological outcome depends on various modifiable and non-modifiable risk factors. Among the modifiable risk factors, admission (stress) hyperglycemia has a deleterious effect on the neurological outcome. It is well known by various studies that diabetic patients have more severe outcome and neurological disability after acute stroke than the non-diabetic patients. Now stress hyperglycemia is also becoming a second serious marker to affect the neurological outcome of these stroke patients. The aim was to study the blood sugar level and it`s correlation with the neurological outcome among the acute ischemic stroke patients on admission and at third month of follow-up. Methods: It is a prospective and comparative study done in a tertiary care hospital. Adult patients (> 40 years) presenting with acute ischemic stroke were neurologically stratified based on National Institutes of Health Stroke Scale (NIHSS) and admission blood sugars were noted. They were subdivided into 3 groups. Group 1 consisting of 31 normoglycemic patients, group 2 consisting of 32 stress hyperglycemic patients and group 3 consisting of 40 Type 2 diabetes mellitus (T2DM) patients. They were again reassessed after 3 months with FBS, PPBS and neurological recovery by NHISS. Chi-square test / fischer exact test was used to compare between 3 groups. A p-value of <0.005 was considered statistically significant. Results: The normoglyceamic individuals had much better functional recovery when compared with stress hyperglyceamia and diabetes mellitus groups (p <0.001) at 3 months. Conclusions: Abnormally high blood sugar at the time of presentation in acute stroke patient, significantly alter functional recovery at 3 rd month of follow-up. Hence admission blood sugar level may be used as a surrogate marker to predict functional recovery.

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Section: Discussionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 91%

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confidence: 99%

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A study of stress hyperglycemia and its relationship with the neurological outcome in patients presenting with acute ischemic stroke

et al. 2016

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“…Уровень гликемии при поступлении являлся независимым предиктором неблагоприятного прогноза при ИМ в госпитальном периоде, наряду с возрастом, глубиной поражения миокарда и уровнем САД при поступлении. там анализа ГГ при поступлении 7,8 ммоль/и обнаружена у 22,6% пациентов без ранее верифицированного СД, что соответствует ранее проведенным исследованиям, в которых ГГ при отсутствии СД-2 имела место в 10-49% случаев [3,12,13].…”

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The Influence of Glycemia on Short-Term Prognosis in Myocardial Infarction Without Anamnesis of 2nd Type Diabetes

Холматова

Дворяшина

Супрядкина³

2014

Cardiovasc Ther Prev

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Aim. To estimate the impact of glycemia recorded during myocardial infarction (MI) in-patient care on short-term prognosis of patients without 2nd type diabetes mellitus (2DM).Material and methods. Totally 296 patients were prospectively investigated. According to glucose levels patients were divided into three groups: 1st with ≤4,0 mM/l (7,4%); 2nd with 4,01–7,79 mM/l (69,9%); 3rd with ≥7,8 mM/l (22,6%). The rate of glucose metabolism disorders and complications during in-hospital care were studied.Results. In 2/3 of patients with glycemia ≥7,8 mM/l at hospitalization, later the changes of glucose metabolism were found by glucosetolerance test: prediabetes (36,9%), 2DM (32,3%). In the patients of 3rd group significantly higher was the rate of 3-vessel disease (41,8%) anf MI complications: congestive left-ventricular failure — 52,2% vs 27,3% in the 1st group and 34,1% in the second (p=0,017), cardiogenic shock — 26,9% vs 4,5% and 6,8% (p<0,001), conduction disorders — 27,3% vs 9,1% and 11,7% (p=0,006), in-hospital mortality — 13,8% vs 4,5% and 4,4% (p=0,025). The risk of death in subjects with glycemia ≥7,8 mM/l was 3,48 (95% CI: 1,41–8,60) times higher than in normoglycemic (p=0,007). The glycemia was independently linked with complications of MI during in-hospital period: OR = 1,128; 95% CI: 1,005–1,266 (p=0,042), — as also with the age, severity of myocardial damage and systolic pressure at admittance.Conclusion. There was higher prevalence of MI complications and 3 times higher risk of death in patients without 2DM, but having ≥7,8 mM/l glucose (22,6% of patients) at admittance. The glycemia parameter was an independent predictor for unfavorable prognosis of MI without previous 2DM diagnosis and should be used as part of secondary prevention care.

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Ischemic Stroke

Humaira

Hayat

Shaikh

et al. 2016

TPMJ

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Objectives: Stroke is continued to rise in developing countries of the world.Early recognition and prompt treatment of poor prognostic factors would reduce mortality andmorbidity. The objective of our study was evaluation of factors affecting prognosis of ischemicstroke patients and to assess thirty days mortality and outcome. Study Design: Crosssectional,prospective study. Setting: Medical wards of Liaquat University Hospital Jamshoro/Hyderabad. Period: August 2009 to February 2011. Material and Methods: 150 patients wascarried out, patients having acute cerebral infarction of either gender, aged equal to or greaterthan 13 years were included while patients of stroke because of hemorrhage, space occupyinglesion and known diabetic were excluded from study. Results: 150 patients were selected,out of them 60% were male. Age of patients ranged from 13- 90 years with median age of51 years. At the end of one month mortality rate was 10% in our study. No improvement wasfound in 16% patients, partial improvement in 62% while only 12% recovered fully. Conclusion:Our study showed high mortality rate in ischemic stroke patients. Males at and after age of50 years develop ischemic stroke more commonly. Patients of ischemic stroke having fever,dysphagia, urinary incontinence, hyperglycemia and altered level of consciousness showedpoor prognosis.

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Admission Hyperglycemia is a Poor Prognostic Sign in Both Diabetics and Non-Diabetics

Cited by 4 publications

References 0 publications

A study of stress hyperglycemia and its relationship with the neurological outcome in patients presenting with acute ischemic stroke

A study of stress hyperglycemia and its relationship with the neurological outcome in patients presenting with acute ischemic stroke

The Influence of Glycemia on Short-Term Prognosis in Myocardial Infarction Without Anamnesis of 2nd Type Diabetes

Ischemic Stroke

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