Hyperglycaemia

Studies have shown that hyperglycaemia is associated with poor outcomes after ischaemic stroke, including in those patients treated with thrombolytic agents [15]. There is an increased intracranial haemorrhage (ICH) rate.

The effects of hyperglycaemia on long-term outcome are similar to those seen after acute myocardial infarction. Known diabetic patients also have poorer outcomes.

The evidence for improved outcome with treatment of hyperglycaemia is not so clear. Current consensus seems to be that patients with acute stroke should be treated, to maintain a glucose concentration between 5 and 15mmol/l (previously 4-11mmol/l), while being careful to avoid hypoglycaemia [1]. This may require the use of an insulin sliding scale and glucose, or the patient’s own oral hypoglycaemic agents, if the patient can swallow