High prevalence of abnormal glucose metabolism and poor sensitivity of fasting plasma glucose in the chronic phase of stroke.
BACKGROUND
Cardiovascular disease is the leading cause of death in long-term stroke survivors, and whole-body glucose metabolism is strongly linked to cardiovascular disease risk. This study provides important preliminary information on the prevalence of abnormal glucose metabolism in chronic stroke patients (mean 3 years after stroke) and reports on the utility of screening for abnormalities using fasting plasma glucose (FPG) in this population.


METHODS
Two hundred and sixteen chronic hemiparetic stroke patients were screened for diabetes status by medical history and FPG. A subset (n = 80) was evaluated by oral glucose tolerance test to assess the utility of screening for abnormalities using FPG alone.


RESULTS
Seventy-five of the 216 (35%) had type 2 diabetes by medical history. Another 70 were either diabetic (n = 11) or had impaired fasting glucose (n = 59) based on a single blood draw at the time of screening. FPG among non-diabetic stroke patients had a sensitivity of 49% for predicting abnormalities in the 2-hour glucose level during oral glucose tolerance test. Cumulative results identify 77% as abnormal (impaired or diabetic) on the basis of medical history, fasting plasma glucose, and/or 2-hour glucose level.


CONCLUSIONS
The prevalence of abnormal glucose metabolism is extremely high in chronic stroke and is underestimated on the basis of FPG.
Ivey
Frederick M
FM
Division of Gerontology, School of Medicine, University of Maryland, Baltimore, MD 21117, USA. fivey@grecc.umaryland.edu
Ryan
Alice S
AS
Hafer-Macko
Charlene E
CE
Garrity
Brian M
BM
Sorkin
John D
JD
Goldberg
Andrew P
AP
Macko
Richard F
RF
D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D002908:Chronic Disease; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000453:epidemiology* / Q000378:metabolism; D005215:Fasting / Q000097:blood*; D005260:Female; D018149:Glucose Intolerance / Q000097:blood / Q000453:epidemiology* / Q000378:metabolism; D005951:Glucose Tolerance Test; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D015995:Prevalence; D012680:Sensitivity and Specificity; D020521:Stroke / Q000097:blood* / Q000378:metabolism; D013997:Time Factors
D001786:Blood Glucose