Patel Vishal N, Kuo Emory
Emory University School of Medicine Neuroscience Critical Care, Emory Healthcare Marcus Neuroscience ICU, Grady Memorial Hospital, 49 Jesse Hill Jr Drive SE, Office # 386, Atlanta, GA, 30303, USA.
Emory University School of Medicine, Atlanta, GA, USA.
Curr Diab Rep. 2021 Dec 1;21(11):48. doi: 10.1007/s11892-021-01416-1.
The purpose of this review is to discuss clinical trials involving glycemic control in hospitalized stroke patients and to review oral medications used in glycemic control. GLP-1 agonists, which have some preliminary studies in ischemic stroke, will also be reviewed.
Until recently, glycemic control targets in hospitalized stroke patients remained unclear. The SHINE (Stroke Hyperglycemia Insulin Network Effort) trial demonstrated no significant difference between aggressive versus standard of care glycemic control in the acute ischemic stroke patient. Although SHINE demonstrated a lack of statistical difference in glycemic control targets, many questions remain including glycemic control in patients with other stroke types (SAH, ICH). The role of non-insulin-based medications in glycemic control for hospitalized stroke patients remains unclear and presents an opportunity for further research. Finally, GLP-1 agonists present an interesting area of research for acute ischemic stroke.
本综述旨在讨论针对住院卒中患者血糖控制的临床试验,并回顾用于血糖控制的口服药物。还将对在缺血性卒中方面有一些初步研究的胰高血糖素样肽-1(GLP-1)激动剂进行综述。
直到最近,住院卒中患者的血糖控制目标仍不明确。“卒中高血糖胰岛素网络研究(SHINE)”试验表明,急性缺血性卒中患者强化血糖控制与标准治疗血糖控制之间无显著差异。尽管SHINE试验表明血糖控制目标缺乏统计学差异,但仍存在许多问题,包括其他卒中类型(蛛网膜下腔出血、脑出血)患者的血糖控制。非胰岛素类药物在住院卒中患者血糖控制中的作用仍不明确,这为进一步研究提供了契机。最后,GLP-1激动剂是急性缺血性卒中一个有趣的研究领域。