Introduction:UK stroke guidelines recommend that glycaemia is monitored, hyperglycaemia treated, and patients are screened for undiagnosed diabetes mellitus.Method:In a multicentre retrospective cohort study we reviewed the nursing and medical records of 112 consecutively admitted patients with acute stroke and TIA, to the three hospitals in one Health and Social Care Trust in Northern Ireland from January 1, 2008 until April 15, 2008. Data were extracted in October to December 2009. We evaluated the management of hyperglycaemia with particular emphasis on the role of nurses in the monitoring of hyperglycaemia, and in the screening of undiagnosed diabetes and obesity. Results:The prevalence of hyperglycaemia ≥ 7.8mmol/litre in each of the first 5 days of admission ranged from 24% to 34%, affecting a total 41 (37%) patients. Eighteen patients had a pre-admission history diabetes mellitus. The decision to commence finger prick glucose monitoring is usually made by nurses. Our study suggests that whilst a history of diabetes mellitus prompted glucose monitoring, more generally among patients with no history of diabetes mellitus, glycaemia was under monitored, and opportunities to identify undiagnosed diabetes could be missed. Obesity is a major predisposing factor to the development of Type 2 diabetes; our findings indicate that just 7% of patients had body mass index testing, and just over half (55%) had a weight recorded. Conclusion: Secondary stroke prevention is reliant on the identification and management of risk factors for cardiovascular disease and stroke nurses have a significant role to play in this area.