Optimum control of blood glucose for prevention and treatment of ischemic and haemorrhagic stroke

Guyomard, Veronique and Myint, Phyo Kyaw (2009) Optimum control of blood glucose for prevention and treatment of ischemic and haemorrhagic stroke. Current Treatment Options in Cardiovascular Medicine, 11. pp. 201-211. ISSN 1534-3189

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Abstract

Stroke is the most common cause of disability and a major cause of mortality. Each year, more than 500,000 Americans sustain a stroke. Reperfusion and antithrombotic therapies are still of limited benefit, hence increasing interest has been focused on therapeutic approaches that prevent and/or modulate infarct evolution. Hyperglycemia in acute stroke has a poor prognosis and is associated with significant morbidity and mortality. However, it remains unclear whether intensive lowering of blood glucose levels in the hyperacute and acute phases of stroke improves clinical outcomes. Experimental data suggest that elevated blood glucose may contribute to infarct expansion directly through a number of maladaptive metabolic pathways and that treatment with insulin may attenuate these adverse effects. Despite some controversy surrounding the optimal level of blood glucose control, much of the evidence to date supports rigorous blood glucose control and comprehensive cardiovascular risk factor management to prevent stroke in patients with diabetes. The current recommendation is to aim for strict control of blood pressure, glucose, and lipids along with lifestyle modification to improve cardiovascular health. However, there remains a distinct paucity of information concerning secondary stroke prevention. To date, the overwhelming evidence suggests that aggressive glucose management should be the standard of care in all patients with stroke and hyperglycemia. This article presents an overview of the recommendations for the optimum control of blood glucose for prevention and treatment of ischemic and hemorrhagic stroke.

Item Type:	Article
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School
UEA Research Groups:	Faculty of Medicine and Health Sciences > Research Groups > Norwich Clinical Trials Unit
Depositing User:	Rhiannon Harvey
Date Deposited:	25 Mar 2011 15:45
Last Modified:	11 Jan 2024 01:21
URI:	https://ueaeprints.uea.ac.uk/id/eprint/27233
DOI:	10.1007/s11936-009-0021-9

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