# Glucose Fluctuations in Acute Ischemic Stroke

## TL;DR

This study explores how glucose fluctuations affect outcomes in acute ischemic stroke patients, finding that better glucose control may improve prognosis.

## Contribution

The study introduces the use of continuous glucose monitoring to assess glucose fluctuations in acute ischemic stroke patients.

## Key findings

- No significant difference in mean glucose levels between stroke subtypes.
- Increased time in glucose range correlates with better patient outcomes.
- Total anterior infarct patients have worse outcomes compared to lacunar patients.

## Abstract

Introduction: The Oxfordshire Community Stroke Project denotes four subtypes of ischemic stroke (total and partial anterior infarct, posterior, and lacunar). Hyperglycemia has been associated with a larger infarct size and poor prognosis.

Aim: The purpose of the study was to investigate the correlation of glucose fluctuations with the Oxford sub-categories and patient outcomes using a blinded continuous glucose monitoring system.

Methods: This is a non-interventional prospective observational study. Stroke patients with symptoms onset in the last 24h, participated in the study. A glucose sensor was placed for 72 hours. Disability was assessed using the modified Rankin Scale. Stroke subtypes were compared with total mean glucose and time in range using ANOVA analysis. Multiple ordinal logistic regression was employed to analyze outcomes and survival.

Results: The sample consisted of 105 diabetic and non-diabetic patients. The overall mean glucose was 127.06 mg/dL and the time in range (70-140 mg/dL) was 70.98%. There was no significant difference between the stroke sub-categories and the total mean glucose. For every one-point increase in the time in range, we expect a 1.5% reduction in the odds of having a worse outcome. Patients with total anterior infarct are 2.31 times more likely to have a worse outcome than lacunar patients.

Conclusion: The utilization of the Oxford classification may not be necessary for managing acute ischemic stroke glucose levels. Achieving glucose regulation and an increase in time in range can be attained through meticulous control, potentially extending life expectancy. Continuous glucose monitors may aid in achieving this objective.