International Journal of Advances in Medicine | July-September 2016 | Vol 3 | Issue 3 Page 546
International Journal of Advances in Medicine
Green SR et al. Int J Adv Med. 2016 Aug;3(3):546-551
http://www.ijmedicine.com pISSN 2349-3925 | eISSN 2349-3933
Research Article
A study of stress hyperglycemia and its relationship with the
neurological outcome in patients presenting with acute ischemic stroke
Siva Ranganathan Green
1
*, Lokesh S.
2
, Tony Kadavanu Mathew
1
, Jayasingh K.
3
,
Ragupathy S.
3
INTRODUCTION
Stroke is a common cause of emergency admission which
is associated with increased mortality, morbidity and poor
quality of life. After coronary artery disease and cancer,
stroke is the 3rd most common cause of death in elderly.
1
The outcome of stroke is influenced by various factors
including severity, type of stroke, predisposing factors,
ABSTRACT
Background: Cerebrovascular accident (CVA) continues to be the most common neurological disease in the
developed and developing countries. It also stands as the 3rd more common cause of death after cardiovascular
disease and cancer. Stroke related burden keeps rising among the patients, their relatives and treating consultants. The
neurological outcome depends on various modifiable and non-modifiable risk factors. Among the modifiable risk
factors, admission (stress) hyperglycemia has a deleterious effect on the neurological outcome. It is well known by
various studies that diabetic patients have more severe outcome and neurological disability after acute stroke than the
non-diabetic patients. Now stress hyperglycemia is also becoming a second serious marker to affect the neurological
outcome of these stroke patients. The aim was to study the blood sugar level and it`s correlation with the neurological
outcome among the acute ischemic stroke patients on admission and at third month of follow-up.
Methods: It is a prospective and comparative study done in a tertiary care hospital. Adult patients (> 40 years)
presenting with acute ischemic stroke were neurologically stratified based on National Institutes of Health Stroke
Scale (NIHSS) and admission blood sugars were noted. They were subdivided into 3 groups. Group 1 consisting of 31
normoglycemic patients, group 2 consisting of 32 stress hyperglycemic patients and group 3 consisting of 40 Type 2
diabetes mellitus (T2DM) patients. They were again reassessed after 3 months with FBS, PPBS and neurological
recovery by NHISS. Chi- square test / fischer exact test was used to compare between 3 groups. A p-value of <0.005
was considered statistically significant.
Results: The normoglyceamic individuals had much better functional recovery when compared with stress
hyperglyceamia and diabetes mellitus groups (p <0.001) at 3 months.
Conclusions: Abnormally high blood sugar at the time of presentation in acute stroke patient, significantly alter
functional recovery at 3
rd
month of follow-up. Hence admission blood sugar level may be used as a surrogate marker
to predict functional recovery.
Keywords: Cerebro vascular accident, Stress hyperglycaemia, Normoglycemia, Diabetes mellitus, National Institute
of Health Stroke Score
1
Assistant Professor,
2
Associate Professor,
3
Professor, Department of General Medicine, Mahatma Gandhi Medical
College and Research Institute, Sri Balaji Vidhyapeeth University, Pondicherry, India
Received: 12 July 2016
Accepted: 16 July 2016
*Correspondence:
Dr. Siva Ranganathan Green,
E-mail: dr.siva.green@gmail.com
Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under
the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.
DOI: http://dx.doi.org/10.18203/2349-3933.ijam20162261