Abstract
Objective: Hyperglycemia is a known risk factor which adversely impacts the outcomes in stroke patients compared to patients with normal blood glucose levels. Patients suffering from an acute stroke who are previously nonhyperglycemic may show elevated blood glucose levels. The present study was designed to measure the outcomes in denovo diabetic and diabetic stroke patients compared to nondiabetics.Methods: A prospective observational study over a period of 6 mo, in which 103 patients were divided into three cohorts based on their blood glucose levels (nondiabetic, denovo diabetic and diabetics). The modified Rankin scale (mRS) score was calculated at in-hospital admission and discharge in these three cohorts. The initial and final scores were correlated and mean differences with respect to outcomes between all the three cohorts was calculated.Results: The mean mRS at the time of hospital admission in diabetics and nondiabetics was 3.6±0.81 and 3.3±0.78 which decreased to 2.8±0.95 and 2.9±0.83 respectively at the time of discharge. The mean mRS score in denovo diabetic stroke patients during in-hospital admission was 4±0.81 which was calculated as 3.7±0.85 at the time of discharge. The mean difference in mRS score in diabetics vs non-diabetics was found to be 0.73±0.8 (p =<0.001). The mean difference in mRS score of denovo diabetics vs non-diabetics and denovo diabetics vs diabetics was 0.30±0.63 and 0.38±0.61 respectively (p = 0.1).Conclusion: Results of these observational study in Indian patients, highlights the need for controlling hyperglycemia in stroke patients to improve outcomes and to prevent mortality arising out of acute stroke attacks.
Highlights
Stroke remains the major cause of morbidity and mortality along with being the major cause of adult disability [1]
We planned an observational study on stroke patients to study the outcomes in relation to blood glucose levels and to determine whether increased glucose levels at hospital admission are associated with poor outcomes
These patients were divided into three cohorts with respect to their blood glucose levels at the time of hospital admission viz diabetics, denovo diabetic and nondiabetic
Summary
Stroke remains the major cause of morbidity and mortality along with being the major cause of adult disability [1]. Despite the advancements in the diagnosis and pharmacotherapy, stroke remains one of the major neurological diseases often causing gross disability and death [3]. Developing countries like India are facing a huge burden of cardiovascular diseases, among which stroke remains one of a leading cause of disability and death. It is estimated that the adjusted prevalence rate of stroke is about 84-262/100,000 in rural and about 334-424/100,000 in urban areas of India. Estimates indicated by Indian Council of Medical Research–ICMR states that among non-communicable diseases (NCD’s), stroke contributes to about 41% deaths and 72% of Disability Adjusted Life Years (DALY) [7]
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