Managing post stroke hyperglycaemia: moderate glycaemic control is better? An update

Post stroke hyperglycaemia (PSH) is prevalent in acute ischaemic stroke (AIS) patients and it has been associated with a dismal outcome of death and disability. Insulin has been proven to attenuate glucose effectively in stroke patients, thus many trials over the years had studied the efficacy of in...

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Main Authors: Wan Sulaiman, Wan Aliaa, Hashim, Hasnur Zaman, Che Abdullah, Shahrin Tarmizi, Hoo, Fan Kee, Basri, Hamidon
Format: Article
Published: IfADo - Leibniz Research Centre for Working Environment and Human Factors 2014
Online Access:http://psasir.upm.edu.my/id/eprint/34437/
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author Wan Sulaiman, Wan Aliaa
Hashim, Hasnur Zaman
Che Abdullah, Shahrin Tarmizi
Hoo, Fan Kee
Basri, Hamidon
author_facet Wan Sulaiman, Wan Aliaa
Hashim, Hasnur Zaman
Che Abdullah, Shahrin Tarmizi
Hoo, Fan Kee
Basri, Hamidon
author_sort Wan Sulaiman, Wan Aliaa
building UPM Institutional Repository
collection Online Access
description Post stroke hyperglycaemia (PSH) is prevalent in acute ischaemic stroke (AIS) patients and it has been associated with a dismal outcome of death and disability. Insulin has been proven to attenuate glucose effectively in stroke patients, thus many trials over the years had studied the efficacy of intensive treatment aiming at normalization of blood sugar level in order to improve the bleak outcomes of PSH. However, tight glycaemic control failed to be translated into clinical benefits and the outcomes are no different from the conventional approach, despite the costly healthcare expenditure invested. On the contrary, it brings more significant harm than the intended benefit, as 1 in every 9 treated patients had symptomatic hypoglycaemia. Thus, the benefits of tight glucose control, if any, are overshadowed by this potential risk of hypoglycaemia causing permanent neurological injury. Therefore, international practice guidelines recommend for less aggressive treatment to maintain blood glucose level within an appropriate range in AIS patients. However, there are limited details for stroke-specific glycaemic management and this made management of PSH particularly difficult. This review is to discuss and provide suggestions concerning glycaemic control in acute ischaemic stroke; the direction of its future prospective clinical trials and the treatment strategy required based on recent literature.
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publishDate 2014
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spelling upm-344372015-12-15T03:04:53Z http://psasir.upm.edu.my/id/eprint/34437/ Managing post stroke hyperglycaemia: moderate glycaemic control is better? An update Wan Sulaiman, Wan Aliaa Hashim, Hasnur Zaman Che Abdullah, Shahrin Tarmizi Hoo, Fan Kee Basri, Hamidon Post stroke hyperglycaemia (PSH) is prevalent in acute ischaemic stroke (AIS) patients and it has been associated with a dismal outcome of death and disability. Insulin has been proven to attenuate glucose effectively in stroke patients, thus many trials over the years had studied the efficacy of intensive treatment aiming at normalization of blood sugar level in order to improve the bleak outcomes of PSH. However, tight glycaemic control failed to be translated into clinical benefits and the outcomes are no different from the conventional approach, despite the costly healthcare expenditure invested. On the contrary, it brings more significant harm than the intended benefit, as 1 in every 9 treated patients had symptomatic hypoglycaemia. Thus, the benefits of tight glucose control, if any, are overshadowed by this potential risk of hypoglycaemia causing permanent neurological injury. Therefore, international practice guidelines recommend for less aggressive treatment to maintain blood glucose level within an appropriate range in AIS patients. However, there are limited details for stroke-specific glycaemic management and this made management of PSH particularly difficult. This review is to discuss and provide suggestions concerning glycaemic control in acute ischaemic stroke; the direction of its future prospective clinical trials and the treatment strategy required based on recent literature. IfADo - Leibniz Research Centre for Working Environment and Human Factors 2014 Article PeerReviewed Wan Sulaiman, Wan Aliaa and Hashim, Hasnur Zaman and Che Abdullah, Shahrin Tarmizi and Hoo, Fan Kee and Basri, Hamidon (2014) Managing post stroke hyperglycaemia: moderate glycaemic control is better? An update. EXCLI Journal, 13. pp. 825-833. ISSN 1611-2156 http://www.excli.de/volume13.php
spellingShingle Wan Sulaiman, Wan Aliaa
Hashim, Hasnur Zaman
Che Abdullah, Shahrin Tarmizi
Hoo, Fan Kee
Basri, Hamidon
Managing post stroke hyperglycaemia: moderate glycaemic control is better? An update
title Managing post stroke hyperglycaemia: moderate glycaemic control is better? An update
title_full Managing post stroke hyperglycaemia: moderate glycaemic control is better? An update
title_fullStr Managing post stroke hyperglycaemia: moderate glycaemic control is better? An update
title_full_unstemmed Managing post stroke hyperglycaemia: moderate glycaemic control is better? An update
title_short Managing post stroke hyperglycaemia: moderate glycaemic control is better? An update
title_sort managing post stroke hyperglycaemia: moderate glycaemic control is better? an update
url http://psasir.upm.edu.my/id/eprint/34437/
http://psasir.upm.edu.my/id/eprint/34437/