The prognostic value of stress hyperglycaemia and previously unrecognized diabetes in acute stroke.
In a prospective study of 86 patients with acute stroke, blood glucose and HbA1 were estimated within 72 h of onset. The prevalence of previously diagnosed diabetes mellitus was 8% whereas 28% could be assumed to have had unrecognized hyperglycaemia preceeding the acute event as identified by a stable HbA1 raised more than two SD above the mean reference value. Complete functional recovery of the limbs within 4 weeks of the stroke was confined to those patients with a normal admission blood glucose. None of the patients with a raised admission blood glucose regained full functional recovery within 4 weeks. Cumulative mortality at 4 weeks was significantly raised in patients with an elevated blood glucose value irrespective of their HbA1 values (p less than 0.05). The prevalence of unrecognized hyperglycaemia as a risk factor for acute stroke is greater than previously reported in the UK and admission blood glucose concentration is of greatest importance in predicting early mortality and morbidity.
D000328:Adult; D000368:Aged; D002561:Cerebrovascular Disorders / Q000209:etiology* / Q000401:mortality; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D003925:Diabetic Angiopathies / Q000209:etiology*; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000150:complications*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012306:Risk; D013312:Stress, Physiological / Q000150:complications*