title: Inordinate glucose variation poststroke is associated with poor neurological improvement in patients without history of diabetes.
abstract: BACKGROUND
  Glucose variation is an important risk factor for the complications of diabetes mellitus. The plasma glucose level poststroke is in continuous fluctuation. However, whether the variation influences neurological improvement remains unknown.
  
  
  OBJECTIVE
  This observational study aimed to investigate the association of glucose variation with neurological improvement poststroke.
  
  
  METHODS
  We consecutively enrolled 216 ischemic stroke patients with no history of diabetes mellitus within 72 h of onset, with instant blood glucose <11.1 mmol/L at admission. The glucometabolic status was evaluated by an oral glucose tolerance test 1 day after admission and 14 days after stroke, respectively. The severity of neurological deficit was assessed with the National Institute of Health Stroke Scale (NIHSS).
  
  
  RESULTS
  Fourteen days after stroke, 31% patients were found to have impaired glucose tolerance and 30.6% were newly diagnosed diabetes mellitus by oral glucose tolerance test. A higher level of instant blood glucose at admission or fasting plasma glucose (FPG) at 1 day correlated with a less neurological improvement. The number of patients with no <20% decrease in NIHSS was significantly decreased in patient group with higher than 30% variation of either FPG or 2-h postprandial glucose. Similar correlation between glucose variation and neurological improvement was also found in 117 patients with 2-h postprandial glucose ≥7.8 mmol/L at 1 day.
  
  
  CONCLUSIONS
  Inordinate glucose variation correlated with less neurological improvement poststroke, giving the evidence that the fluctuation of glucose levels in stroke patients should be taken into consideration during glucose modulation.
authors.affiliation: Department of Neurology, Guangdong Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department, National Key Discipline, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Yu
authors.forename: Cheng-Guo
authors.initials: CG
authors.lastname: Zhang
authors.forename: Su-Ping
authors.initials: SP
authors.lastname: Zhang
authors.forename: Wei-Min
authors.initials: WM
authors.lastname: Xiao
authors.forename: Xiao-Ping
authors.initials: XP
authors.lastname: Pan
authors.forename: Zhen-Hua
authors.initials: ZH
authors.lastname: Liu
authors.forename: Xiao-Fan
authors.initials: XF
authors.lastname: Chu
authors.forename: Qing-Chun
authors.initials: QC
authors.lastname: Gao
authors.forename: An-Ding
authors.initials: AD
authors.lastname: Xu
authors.forename: Zhi-Qiang
authors.initials: ZQ
authors.lastname: Xu
authors.forename: Jin-Sheng
authors.initials: JS
authors.lastname: Zeng
mesh_terms: D001786:Blood Glucose / Q000378:metabolism*; D003920:Diabetes Mellitus / Q000097:blood; D005215:Fasting; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D008297:Male; D015337:Multicenter Studies as Topic; D064887:Observational Studies as Topic; D020127:Recovery of Function / Q000502:physiology; D012720:Severity of Illness Index; D020521:Stroke / Q000097:blood* / Q000503:physiopathology*; D013997:Time Factors
chemical_list: D001786:Blood Glucose
keywords: Acute stroke; Glucose variation; Impaired glucose regulation; Poststroke hyperglycemia