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. 1986 Jan;62(723):7–10. doi: 10.1136/pgmj.62.723.7

The prognostic value of blood glucose and glycosylated haemoglobin estimation in patients with stroke.

N H Cox, J W Lorains
PMCID: PMC2418539  PMID: 3797367

Abstract

In a prospective study of 109 patients admitted to hospital with a provisional diagnosis of acute stroke, 87 were found to have acute hemiplegic stroke lasting more than 24 hours, and did not have any other co-existing life-threatening disorder. In 81 of these patients, blood glucose and glycosylated haemoglobin (HbA1) were measured at the time of admission. Thirteen of these 81 patients (16%) were hyperglycaemic--in 5 cases, normal HbA1 was found in conjunction with hyperglycaemia suggesting that this represented a 'stress' response. There was no significant difference in age or in blood glucose level between those who died as a result of stroke and those who survived. However, hyperglycaemia with normal HbA1 was demonstrated in 4 of 26 patients who died compared to only one of 55 survivors (P less than 0.02), and all 3 patients with blood glucose greater than 10 mmol/l in conjunction with normal HbA1 died as a result of stroke. Biochemical evidence of 'stress' hyperglycaemia in patients with acute stroke suggests a poor prognosis.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Allen C. M. Predicting recovery after acute stroke. Br J Hosp Med. 1984 Jun;31(6):428, 430, 432-4. [PubMed] [Google Scholar]
  2. Asplund K., Hägg E., Helmers C., Lithner F., Strand T., Wester P. O. The natural history of stroke in diabetic patients. Acta Med Scand. 1980;207(5):417–424. doi: 10.1111/j.0954-6820.1980.tb09749.x. [DOI] [PubMed] [Google Scholar]
  3. Feibel J. H., Hardy P. M., Campbell R. G., Goldstein M. N., Joynt R. J. Prognostic value of the stress response following stroke. JAMA. 1977 Sep 26;238(13):1374–1376. [PubMed] [Google Scholar]
  4. Fuller J. H., Shipley M. J., Rose G., Jarrett R. J., Keen H. Mortality from coronary heart disease and stroke in relation to degree of glycaemia: the Whitehall study. Br Med J (Clin Res Ed) 1983 Sep 24;287(6396):867–870. doi: 10.1136/bmj.287.6396.867. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Ginsberg M. D., Welsh F. A., Budd W. W. Deleterious effect of glucose pretreatment on recovery from diffuse cerebral ischemia in the cat. I. Local cerebral blood flow and glucose utilization. Stroke. 1980 Jul-Aug;11(4):347–354. doi: 10.1161/01.str.11.4.347. [DOI] [PubMed] [Google Scholar]
  6. Husband D. J., Alberti K. G., Julian D. G. "Stress" hyperglycaemia during acute myocardial infarction: an indicator of pre-existing diabetes? Lancet. 1983 Jul 23;2(8343):179–181. doi: 10.1016/s0140-6736(83)90169-1. [DOI] [PubMed] [Google Scholar]
  7. Kannel W. B., McGee D. L. Diabetes and cardiovascular disease. The Framingham study. JAMA. 1979 May 11;241(19):2035–2038. doi: 10.1001/jama.241.19.2035. [DOI] [PubMed] [Google Scholar]
  8. Lowe G. D., Jaap A. J., Forbes C. D. Relation of atrial fibrillation and high haematocrit to mortality in acute stroke. Lancet. 1983 Apr 9;1(8328):784–786. doi: 10.1016/s0140-6736(83)91848-2. [DOI] [PubMed] [Google Scholar]
  9. Melamed E. Reactive hyperglycaemia in patients with acute stroke. J Neurol Sci. 1976 Oct;29(2-4):267–275. doi: 10.1016/0022-510x(76)90176-3. [DOI] [PubMed] [Google Scholar]
  10. Oppenheimer S. M., Hoffbrand B. I., Oswald G. A., Yudkin J. S. Diabetes mellitus and early mortality from stroke. Br Med J (Clin Res Ed) 1985 Oct 12;291(6501):1014–1015. doi: 10.1136/bmj.291.6501.1014-a. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Pulsinelli W. A., Levy D. E., Sigsbee B., Scherer P., Plum F. Increased damage after ischemic stroke in patients with hyperglycemia with or without established diabetes mellitus. Am J Med. 1983 Apr;74(4):540–544. doi: 10.1016/0002-9343(83)91007-0. [DOI] [PubMed] [Google Scholar]
  12. Rehncrona S. Biochemical factors influencing recovery in brain ischemia. Acta Neurol Scand Suppl. 1980;78:167–174. doi: 10.1111/j.1600-0404.1980.tb05435.x. [DOI] [PubMed] [Google Scholar]
  13. Riddle M. C., Hart J. Hyperglycemia, recognized and unrecognized, as a risk factor for stroke and transient ischemic attacks. Stroke. 1982 May-Jun;13(3):356–359. doi: 10.1161/01.str.13.3.356. [DOI] [PubMed] [Google Scholar]
  14. Siemkowicz E., Gjedde A. Post-ischemic coma in rat: effect of different pre-ischemic blood glucose levels on cerebral metabolic recovery after ischemia. Acta Physiol Scand. 1980 Nov;110(3):225–232. doi: 10.1111/j.1748-1716.1980.tb06658.x. [DOI] [PubMed] [Google Scholar]
  15. Siemkowicz E. Hyperglycemia in the reperfusion period hampers recovery from cerebral ischemia. Acta Neurol Scand. 1981 Sep;64(3):207–216. doi: 10.1111/j.1600-0404.1981.tb04400.x. [DOI] [PubMed] [Google Scholar]
  16. Thornton W. E., Schellekens A. P., Sanders G. T. Assay of glycosylated haemoglobin using agar electrophoresis. Ann Clin Biochem. 1981 May;18(Pt 3):182–184. doi: 10.1177/000456328101800310. [DOI] [PubMed] [Google Scholar]

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