Managing post stroke hyperglycaemia: moderate glycaemic control is better? An update

Post stroke hyperglycaemia (PSH) is prevalent in (AIS) acute ischaemic stroke patients and it has been associated with a dismal outcome of death and disability. Insulin has been proven to attenuate glucose effectively in stroke patients, thus many trials over the years had studied the efficacy of in...

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Main Authors:	Wan Sulaiman, Wan Aliaa, Hashim, Hasnur Zaman, Che Abdullah, Shahrin Tarmizi, Fan, Kee Hoo, Basri, Hamidon
Format:	Article
Language:	English English English
Published:	Leibniz Research Centre for Working Environment and Human Factors, Dortmund 2014
Subjects:	R Medicine (General) RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
Online Access:	http://irep.iium.edu.my/37841/ http://irep.iium.edu.my/37841/ http://irep.iium.edu.my/37841/2/Hashim_13082014_proof.pdf http://irep.iium.edu.my/37841/5/37841_Managing%20post%20stroke%20hyperglycaemia_SCOPUS.pdf http://irep.iium.edu.my/37841/6/37841_Managing%20post%20stroke%20hyperglycaemia_WoS.pdf

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recordtype	eprints
spelling	iium-378412017-09-20T07:50:16Z http://irep.iium.edu.my/37841/ Managing post stroke hyperglycaemia: moderate glycaemic control is better? An update Wan Sulaiman, Wan Aliaa Hashim, Hasnur Zaman Che Abdullah, Shahrin Tarmizi Fan, Kee Hoo Basri, Hamidon R Medicine (General) RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry Post stroke hyperglycaemia (PSH) is prevalent in (AIS) acute ischaemic stroke patients and it has been associated with a dismal outcome of death and disability. Insulin has been proven to attenuate glucose effectively in stroke patients, thus many trials over the years had studied the efficacy of intensive treatment aiming at normalization of blood sugar level in order to im-prove the bleak outcomes of PSH. However, tight glycaemic control failed to be translated in-to clinical benefits and the outcomes are no different from the conventional approach, despite the costly healthcare expenditure invested. On the contrary, it brings more significant harm than the intended benefit, as 1 in every 9 treated patients had symptomatic hypoglycaemia. Thus, the benefits of tight glucose control, if any, are overshadowed by this potential risk of hypoglycaemia causing permanent neurological injury. Therefore, international practice guidelines recommend for less aggressive treatment to maintain blood glucose level within an appropriate range in AIS patients. However, there are limited details for stroke-specific gly-caemic management and this made management of PSH particularly difficult. This review is to discuss and provide suggestions concerning glycaemic control in acute ischaemic stroke; the direction of its future prospective clinical trials and the treatment strategy required based on recent literature. Leibniz Research Centre for Working Environment and Human Factors, Dortmund 2014-08-13 Article PeerReviewed application/pdf en http://irep.iium.edu.my/37841/2/Hashim_13082014_proof.pdf application/pdf en http://irep.iium.edu.my/37841/5/37841_Managing%20post%20stroke%20hyperglycaemia_SCOPUS.pdf application/pdf en http://irep.iium.edu.my/37841/6/37841_Managing%20post%20stroke%20hyperglycaemia_WoS.pdf Wan Sulaiman, Wan Aliaa and Hashim, Hasnur Zaman and Che Abdullah, Shahrin Tarmizi and Fan, Kee Hoo and Basri, Hamidon (2014) Managing post stroke hyperglycaemia: moderate glycaemic control is better? An update. EXCLI Journal, 13. pp. 825-833. ISSN 1611-2156 http://www.excli.de/volume13.php
repository_type	Digital Repository
institution_category	Local University
institution	International Islamic University Malaysia
building	IIUM Repository
collection	Online Access
language	English English English
topic	R Medicine (General) RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
spellingShingle	R Medicine (General) RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry Wan Sulaiman, Wan Aliaa Hashim, Hasnur Zaman Che Abdullah, Shahrin Tarmizi Fan, Kee Hoo Basri, Hamidon Managing post stroke hyperglycaemia: moderate glycaemic control is better? An update
description	Post stroke hyperglycaemia (PSH) is prevalent in (AIS) acute ischaemic stroke patients and it has been associated with a dismal outcome of death and disability. Insulin has been proven to attenuate glucose effectively in stroke patients, thus many trials over the years had studied the efficacy of intensive treatment aiming at normalization of blood sugar level in order to im-prove the bleak outcomes of PSH. However, tight glycaemic control failed to be translated in-to clinical benefits and the outcomes are no different from the conventional approach, despite the costly healthcare expenditure invested. On the contrary, it brings more significant harm than the intended benefit, as 1 in every 9 treated patients had symptomatic hypoglycaemia. Thus, the benefits of tight glucose control, if any, are overshadowed by this potential risk of hypoglycaemia causing permanent neurological injury. Therefore, international practice guidelines recommend for less aggressive treatment to maintain blood glucose level within an appropriate range in AIS patients. However, there are limited details for stroke-specific gly-caemic management and this made management of PSH particularly difficult. This review is to discuss and provide suggestions concerning glycaemic control in acute ischaemic stroke; the direction of its future prospective clinical trials and the treatment strategy required based on recent literature.
format	Article
author	Wan Sulaiman, Wan Aliaa Hashim, Hasnur Zaman Che Abdullah, Shahrin Tarmizi Fan, Kee Hoo Basri, Hamidon
author_facet	Wan Sulaiman, Wan Aliaa Hashim, Hasnur Zaman Che Abdullah, Shahrin Tarmizi Fan, Kee Hoo Basri, Hamidon
author_sort	Wan Sulaiman, Wan Aliaa
title	Managing post stroke hyperglycaemia: moderate glycaemic control is better? An update
title_short	Managing post stroke hyperglycaemia: moderate glycaemic control is better? An update
title_full	Managing post stroke hyperglycaemia: moderate glycaemic control is better? An update
title_fullStr	Managing post stroke hyperglycaemia: moderate glycaemic control is better? An update
title_full_unstemmed	Managing post stroke hyperglycaemia: moderate glycaemic control is better? An update
title_sort	managing post stroke hyperglycaemia: moderate glycaemic control is better? an update
publisher	Leibniz Research Centre for Working Environment and Human Factors, Dortmund
publishDate	2014
url	http://irep.iium.edu.my/37841/ http://irep.iium.edu.my/37841/ http://irep.iium.edu.my/37841/2/Hashim_13082014_proof.pdf http://irep.iium.edu.my/37841/5/37841_Managing%20post%20stroke%20hyperglycaemia_SCOPUS.pdf http://irep.iium.edu.my/37841/6/37841_Managing%20post%20stroke%20hyperglycaemia_WoS.pdf
first_indexed	2023-09-18T20:54:15Z
last_indexed	2023-09-18T20:54:15Z
_version_	1777410198183346176

Managing post stroke hyperglycaemia: moderate glycaemic control is better? An update

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