title: Glycosylated hemoglobin for diagnosis of prediabetes in acute ischemic stroke patients.
abstract: BACKGROUND
  Prediabetes (PD) is an independent risk factor for stroke. The American Diabetes Association (ADA) has recently published new guidelines recommending glycosylated hemoglobin A1c (HbA1c) as a marker to diagnose diabetes and PD. Diagnosis of diabetes Mellitus (DM) is often made at the time of hospitalization for stroke. Less is known about identifying PD in acute ischemic stroke (AIS) patients. We aim to investigate the frequency of new-onset PD in the hospitalized AIS patients using the new ADA guidelines.
  
  
  METHODS
  We retrospectively studied 362 AIS patients from our local database. Stroke risk factors, type of stroke, and white matter hyperintensities (WMHs) were all collected. Based on the 2010 ADA guidelines, patients were classified as prediabetics, with HbA1c levels of 5.7%-6.4%; diabetics, with HbA1c levels more than 6.5%; and normoglycemic, HbA1c levels less than 5.7%. We used SAS 9.3 for analysis.
  
  
  RESULTS
  On admission, 279 (78%) AIS patients had HbA1c values collected. Stratifying by HbA1c, 113 (31%) AIS patients were given the diagnosis of DM and 109 (30%) were given the diagnosis of PD. From the 166 patients with no DM history, 53% had PD and 15% had DM. Patients with DM and PD were more likely to have hypertension (P<.001) and hyperlipidemia (P=.05). The likelihood of new-onset PD increased with age (P<.01). No differences were found by the type of stroke or WMH.
  
  
  CONCLUSIONS
  Diabetes and PD are highly prevalent in the hospitalized ischemic stroke (IS) patients. Our results suggest a need for routine HbA1c testing in all patients with IS. Further larger studies need to confirm these findings.
authors.affiliation: Department of Neurology, Health Sciences Center, University of New Mexico, Albuquerque, New Mexico. Electronic address: bhuisagarate@salud.unm.edu.
authors.forename: Branko N
authors.initials: BN
authors.lastname: Huisa
authors.forename: Gulmohor
authors.initials: G
authors.lastname: Roy
authors.forename: Jorge
authors.initials: J
authors.lastname: Kawano
authors.forename: Ronald
authors.initials: R
authors.lastname: Schrader
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002545:Brain Ischemia / Q000175:diagnosis / Q000453:epidemiology*; D015897:Comorbidity; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis*; D017408:Guidelines as Topic; D006801:Humans; D008297:Male; D008875:Middle Aged; D009516:New Mexico / Q000453:epidemiology; D017410:Practice Guidelines as Topic; D011236:Prediabetic State / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology*; D011237:Predictive Value of Tests; D015995:Prevalence; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis / Q000453:epidemiology*
chemical_list: D015415:Biomarkers; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human
keywords: Acute ischemic stroke; diabetes; hospitalization; prediabetes