|
|
 |
 |
| |
 Printable version |
Hyperglycemia and diabetes mellitus in acute stroke |
Neurologie.com. Volume 1, Number 6, 188-91, octobre 2009, Revue flash
|
 Résumé
Article gratuit
|
Author(s) : Fanny Herisson, Benoît Guillon |
Summary : Diabetes mellitus is one of the main cardiovascular risk factor. It predisposes to ischemic stroke rather than hemorrhagic ones, and cerebral infarctions are more likely to be lacunars or associated with large artery atherosclerosis. Hyperglycemia is often found (frequent) at acute stage, up to 40% of cases. Acute hyperglycemia may be related to known or unknown previous diabetes or to a stress response. Whatever its origin, hyperglycemia is an independent predictor of poor outcome in acute stroke. It is associated with a lower rate of recanalisation after thrombolysis and an increase risk of haemorrhagic transformation. In fact thrombolytic therapy is contraindicated when glycemia ≥ 22 mmol/L. However, benefits of strict control of glycemia are still unproven and current recommendations emphasize the treatmentof hyperglycemia using insulin when its level reaches 10 mmol/L. Diabetic patients carry high risk of recurrence, which suggests a screening for other arterial territories involved and strict control of all vascular risk factors. |
Keywords : diabetes mellitus, cerebral infarction, stroke, hyperglycemia, thrombolysis |
|
