Glycemia management in acute ischemic stroke: current concepts and novel therapeutic targets

Postgraduate Medicine
Lina PalaiodimouGeorgios Tsivgoulis

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.

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Citations

Aug 19, 2020·QJM : Monthly Journal of the Association of Physicians·Jinghao Nicholas NgiamLeonard L L Yeo
May 18, 2020·Journal of Neurointerventional Surgery·Noel van HornFabian Flottmann
Aug 25, 2020·Journal of Thrombosis and Thrombolysis·Giovanni MerlinoMariarosaria Valente
Sep 29, 2020·Neuropsychiatric Disease and Treatment·Zhonglun ChenYun Zhang
Jun 1, 2021·Frontiers in Neurology·Elena SpronkGlen C Jickling
Jul 17, 2021·Neural Regeneration Research·Federica FerrariRoberto Federico Villa

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