Department of Neurology, Medical College of Georgia at Augusta University, Augusta, GA, USA.
Curr Neurol Neurosci Rep. 2022 Nov;22(11):781-787. doi: 10.1007/s11910-022-01236-0. Epub 2022 Oct 10.
Diabetes mellitus (DM) causes systemic vascular complications. Chronic hyperglycemia is a hallmark of DM and appears to be at least partially responsible for the vascular complications. In addition, hyperglycemia during acute tissue injury has been postulated to augment the injury. This review addresses the potential therapeutic benefits related to ischemic stroke from lowering hyperglycemia in two settings, in chronic hyperglycemia and during acute ischemic stroke.
A recent efficacy trial to lower hyperglycemia during acute ischemic stroke showed no significant benefit overall as well as in patient subgroups. This finding helps to establish good clinical practice protocols for patients with acute ischemic stroke and hyperglycemia. Hyperglycemia appears to be a key mediator of the systemic vascular complications of DM. Despite current lack of evidence that lowering hyperglycemia during acute ischemic stroke improves functional outcome, unanswered questions remain in specific acute ischemic stroke settings that warrant additional research.
糖尿病（DM）会引起全身血管并发症。慢性高血糖是 DM 的一个标志，似乎至少部分导致了血管并发症。此外，急性组织损伤期间的高血糖被认为会加重损伤。本综述讨论了在两种情况下降低高血糖与缺血性中风相关的潜在治疗益处，即慢性高血糖和急性缺血性中风期间。
最近一项降低急性缺血性中风期间高血糖的疗效试验并未显示出总体上以及在患者亚组中的显著益处。这一发现有助于为急性缺血性中风和高血糖患者建立良好的临床实践方案。高血糖似乎是 DM 全身血管并发症的关键介质。尽管目前没有证据表明降低急性缺血性中风期间的高血糖可以改善功能结局，但在特定的急性缺血性中风情况下仍存在未解决的问题，需要进一步研究。
