Glycemia management in acute ischemic stroke: current concepts and novel therapeutic targets |
| |
| Authors: | Lina Palaiodimou Vasileios-Arsenios Lioutas Vaia Lambadiari George P. Paraskevas Konstantinos Voumvourakis Georgios Tsivgoulis |
| |
| Affiliation: | 1. Second Department of Neurology, “Attikon” University Hospital, National and Kapodistrian University of Athens, Athens, Greecelina_palaiodimou@yahoo.gr;3. Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA;4. Second Department of Internal Medicine, Research Institute and Diabetes Center, Athens University Medical School, “Attikon” University Hospital, Haidari, Greece;5. Cognitive and Movement Disorders Unit and Unit of Neurochemistry and Biological Markers, First Department of Neurology, “Eginition” University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece;6. Second Department of Neurology, “Attikon” University Hospital, National and Kapodistrian University of Athens, Athens, Greece;7. Department of Neurology, University of Tennessee Health Science Center, Memphis, TN, USA |
| |
| Abstract: | ![]()
Hyperglycemia on hospital admission is a common phenomenon in acute ischemic stroke patients and represents an independent predictor of poor clinical outcome with or without acute recanalization therapies (systemic thrombolysis or mechanical thrombectomy). Effective restoration of normoglycemia is considered to be beneficial, but conclusive evidence from randomized controlled clinical trials and specific recommendations are lacking. In addition, aggressive glucose control can be complicated by hypoglycemia leading to early neurological deterioration. We conducted a systematic literature review with the aim of addressing several questions: timing of glucose control, target range, type of insulin delivery, duration and practicability of glucose-lowering protocols. Special issues regarding mechanical thrombectomy and glycemic variability can then be investigated in future trials which are also being considered. |
| |
| Keywords: | Glycemia management acute ischemic stroke post-stroke hyperglycemia recanalization therapy glycemic variability |
|
|
