Practice changing: NIH study provides answer to long-held debate on blood sugar control after stroke

Hyperglycemia is common in patients with acute ischemic stroke and is associated with worse outcomes compared to normal glucose levels.

It has often been debated whether intensive glucose management, which requires the use of IV insulin to bring blood sugar levels down to 80-130 mg/dL, or standard glucose control using insulin shots, which aims to get glucose below 180 mg/dL, lead to better outcomes after stroke.

Primary results from the Stroke Hyperglycemia Insulin Network Effort (SHINE) study, a large, multisite clinical study presented at a plenary session at the International Stroke Conference in Honolulu on Feb. 6, 2019 provide a clear answer to that question.

The primary results show that intensive glucose management did not improve functional outcomes at 90 days after stroke compared to standard glucose therapy.

In addition, intense glucose therapy increased the risk of very low blood glucose (hypoglycemia) and required a higher level of care such as increased supervision from nursing staff, compared to standard treatment.

(Source: NIH, Feb. 6, 2019)

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