Kazemi Rouzbeh, Amirbaigloo Alireza, Ghotbi Ali, Nazifi Mahsa, Soheilipour Fahimeh
Tabassom Stroke Rehabilitation Clinic, Tehran, Iran.
Practicing in Private Office, Tehran, Iran.
Med J Islam Repub Iran. 2024 Feb 21;38:19. doi: 10.47176/mjiri.38.19. eCollection 2024.
Hyperglycemia is common in the early acute stroke phase especially in patients with diabetes. To the best of our knowledge, no study has evaluated the course of hyperglycemia in patients with diabetes during the post-stroke recovery phase.
It was an observational study conducted in Tabassom Rehabilitation Center for Stroke Patients, Tehran, Iran, 2018-2021. Forty-seven consecutive patients with diabetes and stroke were enrolled and included if at least 3 months had passed from their stroke . Any change in glycemic control before and after stroke was controlled by monitoring drugs used for diabetes treatment and laboratory results. To assess categorical variables, the Pearson chi-squared test was used. Quantitative variables before and after the stroke were analyzed by the paired sample t-test.
The mean age was 63.6 ± 6.9 years, and 22 patients were women. The median time from occurrence of stroke to the first visit was 5 months and 6 days. Glycemic control improved among patients with diabetes during the post-stroke recovery phase. There was a significant decrease of 0.7 ± 1.3 % in HbA1c ( = 0.001). The number and the dose of drugs needed for diabetes treatment decreased. No significant correlation could be found between changes in HbA1c and weight.
Despite the initial increase in glycemia in patients with diabetes in the acute phase of stroke, glycemic control improves after stroke, and often, it is necessary to decrease diabetes drugs to prevent hypoglycemia. This topic is important and should be addressed by guidelines and institutions involved in the care of patients with diabetes and stroke.
高血糖在急性卒中早期很常见,尤其是在糖尿病患者中。据我们所知,尚无研究评估糖尿病患者在卒中后恢复阶段的高血糖病程。
这是一项于2018 - 2021年在伊朗德黑兰塔巴萨姆卒中患者康复中心进行的观察性研究。连续纳入47例糖尿病合并卒中患者,纳入标准为距卒中发作至少已过去3个月。通过监测糖尿病治疗所用药物及实验室检查结果来控制卒中前后血糖控制的任何变化。采用Pearson卡方检验评估分类变量。对卒中前后的定量变量采用配对样本t检验进行分析。
平均年龄为63.6±6.9岁,22例为女性。从卒中发作到首次就诊的中位时间为5个月零6天。糖尿病患者在卒中后恢复阶段的血糖控制得到改善。糖化血红蛋白(HbA1c)显著下降0.7±1.3%(P = 0.001)。糖尿病治疗所需药物的数量和剂量减少。HbA1c变化与体重之间未发现显著相关性。
尽管糖尿病患者在卒中急性期血糖最初会升高,但卒中后血糖控制会改善,而且通常需要减少糖尿病药物剂量以预防低血糖。这一话题很重要,糖尿病和卒中患者护理方面的指南及机构应予以关注。