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DOI: 10.4103/jdep.jdep_15_21
The impact of hyperglycemia on stroke outcomes in patients with and without diabetes
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Introduction: Diabetes mellitus is a well-established independent risk factor for the development of stroke. It increases stroke risk by about fourfold. Information is scarce on the prevalence of stroke in the Gulf region. A systematic review of stroke epidemiology in the Middle East reported an increase in stroke cases over the last decade. Objectives: We aimed to examine the relationship between adverse stroke outcomes and dysglycemia. Patients and Methods: In this observational, retrospective, cross-sectional study, we recruited 496 patients with a clinical and radiological stroke diagnosis. We compared the length of hospital stay (LOS), inhospital mortality, and 30-day stroke readmission among those with no diabetes, prediabetes, and diabetes. Results: A total of 496 patients were eligible for the inclusion in the study. They were subdivided into three main categories based on their glycemic status according to the Hemoglobin A1c values at presentation. nondiabetes (190), prediabetes (117) and diabetes (189). The mean age was 57 years, with a higher proportion of males (n = 356) than females (n = 140). There were proportionally more ischemic strokes (n = 350) than hemorrhagic strokes (n = 147). The mean LOS was 5.0 days for all patients, irrespective of their glycemic status. Inhospital mortality was 4%, with slightly higher mortality (5.3%) in the group with diabetes; however, this was not statistically significant. Glycemic status did not seem to impact the stroke readmission at 3 or 6 months significantly. Furthermore, the proportion of patients readmitted within 30 days of discharge was not different between the three categories. Conclusions: Ischemic strokes occur in a much higher proportion in our patients with diabetes. Dysglycemia did not significantly impact stroke outcomes in our cohort.
Keywords
Diabetes - hemorrhagic cerebrovascular events - hyperglycemia - hypertension - ischemic cerebrovascular events - outcomesFinancial support and sponsorship
Nil.
Publikationsverlauf
Eingereicht: 11. April 2021
Angenommen: 28. April 2021
Artikel online veröffentlicht:
06. Juli 2022
© 2021. Gulf Association of Endocrinology and Diabetes (GAED). All rights reserved. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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References
- 1 Chen R, Ovbiagele B, Feng W. Diabetes and stroke: Epidemiology, pathophysiology, pharmaceuticals and outcomes. Am J Med Sci 2016;351:380-6.
- 2 Tun NN, Arunagirinathan G, Munshi SK, Pappachan JM. Diabetes mellitus and stroke: A clinical update. World J Diabetes 2017;8:235-48.
- 3 Brownlee M. The pathobiology of diabetic complications: A unifying mechanism. Diabetes 2005;54:1615-25.
- 4 IDF Diabetes Atlas 9th Edition; 2019. Available from: https://www.diabetesatlas.org/en/. [Last accessed on 2020 Aug 16; Last updated on 2020 Sep 14].
- 5 El-Hajj M, Salameh P, Rachidi S, Hosseini H. The epidemiology of stroke in the Middle East. Eur Stroke J 2016;1:180-98.
- 6 Drozdowska BA, Singh S, Quinn TJ. Thinking about the future: A review of prognostic scales used in acute stroke. Front Neurol 2019;10:274.
- 7 Lau LH, Lew J, Borschmann K, Thijs V, Ekinci EI. Prevalence of diabetes and its effects on stroke outcomes: A meta-analysis and literature review. J Diabetes Investig 2019;10:780-92.
- 8 Liao CC, Shih CC, Yeh CC, Chang YC, Hu CJ, Lin JG, et al. Impact of diabetes on stroke risk and outcomes: Two nationwide retrospective cohort studies. Medicine (Baltimore) 2015;94:e2282.
- 9 Hill MD. Stroke and diabetes mellitus. In: Zochodne DW, Malik RA, editors. Handbook of Clinical Neurology. Vol. 126. The Netherlands: Elsevier Health Sciences; 2014. p. 167-74. [doi: 10.1016/B978-0-444-53480-4.00012-6].
- 10 Boulanger M, Al-Shahi Salman R, Kerssens J, Wild SH, Scottish Diabetes Research Network Epidemiology Group. Association between diabetes mellitus and incidence of intracerebral haemorrhage and case fatality rates: A retrospective population-based cohort study. Diabetes Obes Metab 2017;19:1193-7.
- 11 Bellolio MF, Gilmore RM, Ganti L. Insulin for glycaemic control in acute ischaemic stroke. Cochrane Database Syst Rev 2014:CD005346. doi: 10.1002/14651858.CD005346.pub4. PMID: 24453023.
- 12 Tziomalos K, Dimitriou P, Bouziana SD, Spanou M, Kostaki S, Angelopoulou SM, et al. Stress hyperglycemia and acute ischemic stroke in-hospital outcome. Metabolism 2017;67:99-105.
- 13 Li J, Quan K, Wang Y, Zhao X, Li Z, Pan Y, et al. Effect of stress hyperglycemia on neurological deficit and mortality in the acute ischemic stroke people with and without diabetes. Front Neurol 2020;11:576895.
- 14 Sung JY, Chen CI, Hsieh YC, Chen YR, Wu HC, Chan L, et al., (2017). Comparison of admission random glucose, fasting glucose, and glycated hemoglobin in predicting the neurological outcome of acute ischemic stroke: a retrospective study. PeerJ, 5, e2948. https://doi.org/10.7717/peerj.2948.
- 15 Guo Y, Wang G, Jing J, Wang A, Zhang X, Meng X, et al. Stress hyperglycemia may have higher risk of stroke recurrence than previously diagnosed diabetes mellitus. Aging (Albany NY) 2021;13:9108-18.