Effect of hyperglycemia on stroke outcomes.

OBJECTIVE: To review published data about the relationship between hyperglycemia and the outcome of patients with stroke.
RESULTS: Stroke is the most frequent cause of permanent disability in the Western world and the third leading cause of death among Americans. Each year, more than 500,000 Americans have a cerebrovascular accident. In the medical literature, numerous reports have discussed how hyperglycemia during acute stroke, regardless of a patient's prior diabetes status, has been associated with significantly higher morbidity, higher mortality, longer hospital stays, reduced long-term recovery, and diminished ability to return to work. In the United States alone, an estimated $300 million in additional health-care costs are incurred among hospitalized patients with stroke who also have high blood glucose levels. Treatment of hyperglycemia has safely, successfully, and effectively yielded glucose levels in the normal range in the hospital setting under the direction of specialty physicians and should be implemented in patients with stroke.
CONCLUSION: Until convincing randomized prospective trials prove that tight glycemic control does not improve stroke outcomes, the overwhelming preponderance of data suggests that aggressive glucose management should be the standard care in all patients with stroke and hyperglycemia.