Efficacy of intensive control of glucose in stroke prevention: a meta-analysis of data from 59,197 participants in 9 randomized controlled trials.
BACKGROUND
The efficacy of treatments that lower glucose in reducing the risk of incident stroke remains unclear. We therefore did a systematic review and meta-analysis to evaluate the efficacy of intensive control of glucose in the prevention of stroke.


RESULTS
We systematically searched Medline, EmBase, and the Cochrane Library for trials published between 1950 and June, 2012. We included randomized controlled trials that reported on the effects of intensive control of glucose on incident stroke compared with standard care. Summary estimates of relative risk (RR) reductions were calculated with a random effects model, and the analysis was further stratified by factors that could affect the treatment effects. Of 649 identified studies, we included nine relevant trials, which provided data for 59,197 patients and 2037 events of stroke. Overall, intensive control of glucose as compared to standard care had no effect on incident stroke (RR, 0.96; 95%CI 0.88-1.06; P = 0.445). In the stratified analyses, a beneficial effect was seen in those trials when body mass index (BMI) more than 30 (RR, 0.86; 95%CI: 0.75-0.99; P = 0.041). No other significant differences were detected between the effect of intensive control of glucose and standard care when based on other subset factors.


CONCLUSIONS
Our study indicated intensive control of glucose can effectively reduce the risk of incident stroke when patients with BMI more than 30.
Department of Neurosurgery, Shanghai Seventh People's Hospital, Shanghai, People's Republic of China.
Chi
C
Zhang
Yu-Hao
YH
Zhou
Chun-Li
CL
Xu
Feng-Ling
FL
Chi
Hai-Ning
HN
Ju
D000368:Aged; D001786:Blood Glucose / Q000032:analysis*; D015992:Body Mass Index; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018670:Monitoring, Ambulatory / Q000706:statistics & numerical data; D016032:Randomized Controlled Trials as Topic; D012044:Regression Analysis; D018570:Risk Assessment; D020521:Stroke / Q000097:blood* / Q000517:prevention & control*
D001786:Blood Glucose