The Role of Hyperglycemia in Acute Stroke

Abstract

Most studies show the deleterious effect of early hyperglycemia, especially in patients with nonlacunar focal or global ischemia. Clinical trials of intensive insulin treatment are needed. Meanwhile simple measures to avoid excessive hyperglycemia are recommended.

Predicting Role of Prestroke Glycemic Variability Estimated by Glycated Albumin for Reperfusion and Prognosis after Endovascular Treatment

“…Our results were consistent with previous studies which addressed the impact of GA on stroke outcomes in general ischemic stroke patients [20, 23]. In addition, aggravating micro-/macroangiopathy via glycemic fluctuation increases disruption of the blood-brain barrier and inhibition of plasma fibrinolysis and may be lead for hemorrhagic transformation after EVT [4, 34]. This mechanism could explain the impact of GA on SHT after EVT in our study.…”

Predicting Role of Prestroke Glycemic Variability Estimated by Glycated Albumin for Reperfusion and Prognosis after Endovascular Treatment

“…Our results were consistent with previous studies which addressed the impact of GA on stroke outcomes in general ischemic stroke patients [20, 23]. In addition, aggravating micro-/macroangiopathy via glycemic fluctuation increases disruption of the blood-brain barrier and inhibition of plasma fibrinolysis and may be lead for hemorrhagic transformation after EVT [4, 34]. This mechanism could explain the impact of GA on SHT after EVT in our study.…”

Role of AT1 receptors and NAD(P)H oxidase in diabetes-aggravated ischemic brain injury

“…Third, the AT 1 -R antagonist candesartan reduced NAD(P)H oxidase expression and lipid peroxidation, decreased brain injury, and improved neurological function in this combined rat model of diabetes and cerebral ischemia. Our results are consistent with those of others, showing that an elevated level of angiotensin II in diabetes augmented NAD(P)H oxidase expression, increased reactive oxygen species and lipid peroxidation (42), and enhanced brain injury after cerebral ischemia in patients (6,29). Our data are also consistent with published studies showing that angiotensin-converting enzyme inhibitors and angiotensin II receptor antagonists (such as candesartan) can be used to manage diabetic complications (41).…”

Impact of Admission Glucose and Diabetes on Recanalization and Outcome after Intra-Arterial Thrombolysis for Ischaemic Stroke

“…Recanalization has been reported to be the strongest predictor of favourable outcome in previous studies (23,24). The lacking association of vessel recanalization with diabetes and glucose value in our series is in contrast to the results of previous studies reporting lower recanalization rates after IVT in patients with hyperglycaemia (4) and diabetes (9·1% in diabetics vs. 66% in non-diabetics) (9).…”

Predicting Role of Prestroke Glycemic Variability Estimated by Glycated Albumin for Reperfusion and Prognosis after Endovascular Treatment

“…Our results were consistent with previous studies which addressed the impact of GA on stroke outcomes in general ischemic stroke patients [20, 23]. In addition, aggravating micro-/macroangiopathy via glycemic fluctuation increases disruption of the blood-brain barrier and inhibition of plasma fibrinolysis and may be lead for hemorrhagic transformation after EVT [4, 34]. This mechanism could explain the impact of GA on SHT after EVT in our study.…”

Role of AT1 receptors and NAD(P)H oxidase in diabetes-aggravated ischemic brain injury

“…Third, the AT 1 -R antagonist candesartan reduced NAD(P)H oxidase expression and lipid peroxidation, decreased brain injury, and improved neurological function in this combined rat model of diabetes and cerebral ischemia. Our results are consistent with those of others, showing that an elevated level of angiotensin II in diabetes augmented NAD(P)H oxidase expression, increased reactive oxygen species and lipid peroxidation (42), and enhanced brain injury after cerebral ischemia in patients (6,29). Our data are also consistent with published studies showing that angiotensin-converting enzyme inhibitors and angiotensin II receptor antagonists (such as candesartan) can be used to manage diabetic complications (41).…”

Impact of Admission Glucose and Diabetes on Recanalization and Outcome after Intra-Arterial Thrombolysis for Ischaemic Stroke

“…Recanalization has been reported to be the strongest predictor of favourable outcome in previous studies (23,24). The lacking association of vessel recanalization with diabetes and glucose value in our series is in contrast to the results of previous studies reporting lower recanalization rates after IVT in patients with hyperglycaemia (4) and diabetes (9·1% in diabetics vs. 66% in non-diabetics) (9).…”

Predicting Role of Prestroke Glycemic Variability Estimated by Glycated Albumin for Reperfusion and Prognosis after Endovascular Treatment

“…Our results were consistent with previous studies which addressed the impact of GA on stroke outcomes in general ischemic stroke patients [20, 23]. In addition, aggravating micro-/macroangiopathy via glycemic fluctuation increases disruption of the blood-brain barrier and inhibition of plasma fibrinolysis and may be lead for hemorrhagic transformation after EVT [4, 34]. This mechanism could explain the impact of GA on SHT after EVT in our study.…”

Role of AT1 receptors and NAD(P)H oxidase in diabetes-aggravated ischemic brain injury

“…Third, the AT 1 -R antagonist candesartan reduced NAD(P)H oxidase expression and lipid peroxidation, decreased brain injury, and improved neurological function in this combined rat model of diabetes and cerebral ischemia. Our results are consistent with those of others, showing that an elevated level of angiotensin II in diabetes augmented NAD(P)H oxidase expression, increased reactive oxygen species and lipid peroxidation (42), and enhanced brain injury after cerebral ischemia in patients (6,29). Our data are also consistent with published studies showing that angiotensin-converting enzyme inhibitors and angiotensin II receptor antagonists (such as candesartan) can be used to manage diabetic complications (41).…”

Impact of Admission Glucose and Diabetes on Recanalization and Outcome after Intra-Arterial Thrombolysis for Ischaemic Stroke

“…Recanalization has been reported to be the strongest predictor of favourable outcome in previous studies (23,24). The lacking association of vessel recanalization with diabetes and glucose value in our series is in contrast to the results of previous studies reporting lower recanalization rates after IVT in patients with hyperglycaemia (4) and diabetes (9·1% in diabetics vs. 66% in non-diabetics) (9).…”