Stroke Patients with High Blood Sugar at Higher Risk of Death
INDIANAPOLIS -- Stroke patients who have hyperglycemia (high blood sugar)
at the time of admission to the hospital for treatment of the stroke are
at higher risk of death than stroke patients with normal blood sugar levels,
according to a study published in the July 9 issue of the journal Neurology
by researchers from the Indiana University School of Medicine, the Richard
L. Roudebush Veterans Administration Medical Center and the Regenstrief
Institute for Health Care.
The researchers led by the study’s principal investigator, Linda
S. Williams, M.D., assistant professor of neurology at the IU School of
Medicine, analyzed the electronic medical records of 656 stroke patients
hospitalized over a five-year period. Over 40 percent of these stroke
patents had high blood sugar levels. Although most had previous diagnoses
of diabetes, they did not have their blood sugar levels under control.
Dr. Williams and her colleagues found that having high blood sugar when
the stroke occurred put patients at risk for higher 30-day, 1-year and
5-year mortality than if blood sugar levels were in the normal range.
Patients with high blood sugar also stayed longer in the hospital and
had higher hospital costs than those with normal blood sugar.
The researchers also reported that during hospitalization, the patients’
hyperglycemia usually was not adequately addressed, with more than 90%
of the hyperglycemic patients continuing to have high blood sugar during
their hospital stay. They noted that although many treatments are available
to lower blood sugar, improvements are needed in the implementation of
these treatments during hospitalization.
“Diabetes is a growing problem in the United States. With the link
shown in our study between diabetes and poor outcome after stroke, hyperglycemia
at the time of stroke may become an even greater problem in years ahead
both in terms of deaths and medical costs,” says Dr. Williams.
Data used in the study was obtained from the Regenstrief Medical Records
System, a physician-designed integrated inpatient and outpatient information
system that is the largest coded, continuously operated electronic medical
records system in the country.
"In the past, strokes and their devastating outcomes were considered
almost 'acts of God,' a 'stroke' out of the blue. Now we know that they
can be prevented, and once they occur, their consequences can be minimized
through the use of thrombolytic 'clot-busting' drugs. This new study shows
that other metabolic abnormalities such as hyperglycemia may also have
substantial effects on outcomes of strokes. I hope this important yet
preliminary study will lead to a controlled trial of tight blood glucose
control among stroke patients with diabetes," notes William Tierney,
M.D., senior author of the study.
The National Institutes of Health recently funded this group of IU School
of Medicine neurologists and endocrinologists to conduct a phase II study
of rapid normalization of high blood sugar at the time of stroke. “This
treatment is potentially very appealing,” says Dr. Williams, “because
it is available at any hospital and is familiar to all physicians, so
it could be widely used without major changes in the current health care
system.”
The current study was supported by funding from the Indiana University Diabetes Research and Training Center.
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Media Contact: Cindy Fox Aisen
317-274-7722
caisen@iupui.edu
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