The dynamic of glycaemia among adults admitted to hospital with acute stroke: Implications for practice from a cohort study

Aims: Hyperglycaemia is commonly observed among adults admitted to hospital with acute stroke. This study aimed to identify and analyse the dynamic of glycaemia over the first five days since admission to hospital, and to explore the extent to which clinicians intervened to monitor glycaemia. Methods: The records of 112 adults consecutively admitted with acute stroke or TIA to one Health and Social Care Trust in Northern Ireland (1 January to 15 April 2008) were retrospectively reviewed. Glucose levels and monitoring practice were compared between patients with and without pre-admission diagnosed diabetes mellitus and between patients with primary haemorrhagic stroke and those with ischaemic stroke or transient ischaemic attack. Results: Average age was 74 yrs, 46% were male. 16% patients had diagnosed diabetes mellitus, 85% had ischaemic stroke or TIA. Hyperglycaemia ≥7.8mmol/L in first five days ranged from 24%-34%. Day 1, there was a significant difference in highest glucose levels between patients with and without pre-admission diagnosed diabetes mellitus (M=10.3,SD=3.5 versus M=7.1,SD=2.4; t(20.9)=3.5, p=0.002, 95% CI 1.3-4.97), differences were also significant day 2 and 4. Patients with ischaemic stroke had significantly lower glucose levels, on day 1 only, than patients with primary haemorrhagic stroke (M=7.5,SD=2.8 versus M=9.4,SD=3.4; t(92)=-2.09, p