title: Glucose in prediabetic and diabetic range and outcome after stroke.
abstract: OBJECTIVE
  Newly diagnosed disturbed glucose metabolism is highly prevalent in patients with stroke. Limited data are available on their prognostic value on outcome after stroke. We aimed to assess the association of glucose in the prediabetic and diabetic range with unfavourable short-term outcome after stroke.
  
  
  METHODS
  We included 839 consecutive patients with ischemic stroke and 168 patients with intracerebral haemorrhage. In all nondiabetic patients, fasting glucose levels were determined on day 2-4. Prediabetic range was defined as fasting glucose of 5.6-6.9 mmol/L, diabetic range as ≥7.0 mmol/L, pre-existent diabetes as the use of anti-diabetic medication prior to admission. Outcome measures were poor functional outcome or death defined as modified Rankin Scale (mRS) score >2 and discharge not to home. The association of prediabetic range, diabetic range and pre-existent diabetes (versus normal glucose) with unfavourable outcome was expressed as odds ratios, estimated with multiple logistic regression, with adjustment for prognostic factors.
  
  
  RESULTS
  Compared with normal glucose, prediabetic range (aOR 1.8; 95%CI 1.1-2.8), diabetic range (aOR 2.5; 95%CI 1.3-4.9) and pre-existent diabetes (aOR 2.6; 95%CI 1.6-4.0) were associated with poor functional outcome or death. Patients in the prediabetic range (aOR 0.6; 95%CI 0.4-0.9), diabetic range (aOR 0.4; 95%CI 0.2-0.9) and pre-existent diabetes (aOR 0.6; 95%CI 0.4-0.9) were more likely not to be discharged to home.
  
  
  CONCLUSIONS
  Patients with glucose in the prediabetic and diabetic range have an increased risk of unfavourable short-term outcome after stroke. These findings illustrate the potential impact of early detection and treatment of these patients.
authors.affiliation: Neurology, Medisch Spectrum Twente, Enschede, Overijssel, Netherlands.
authors.forename: E
authors.initials: E
authors.lastname: Osei
authors.affiliation: Erasmus MC, Rotterdam, Zuid-Holland, Netherlands.
authors.forename: S
authors.initials: S
authors.lastname: Fonville
authors.affiliation: Internal Medecine, Ikazia Ziekenhuis, Rotterdam, Netherlands.
authors.forename: A A M
authors.initials: AA
authors.lastname: Zandbergen
authors.affiliation: Erasmus MC, Rotterdam, Zuid-Holland, Netherlands.
authors.forename: P J
authors.initials: PJ
authors.lastname: Koudstaal
authors.affiliation: Erasmus MC, Rotterdam, Zuid-Holland, Netherlands.
authors.forename: D W J
authors.initials: DW
authors.lastname: Dippel
authors.affiliation: Neurology, Medisch Spectrum Twente, Enschede, Overijssel, Netherlands.
authors.forename: H M
authors.initials: HM
authors.lastname: den Hertog
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000378:metabolism*; D002543:Cerebral Hemorrhage / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D005947:Glucose / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D011236:Prediabetic State / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology; D012042:Registries; D020521:Stroke / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D005947:Glucose
keywords: diabetes; glucose; outcome; prediabetes; prognosis; stroke