Hypoglycaemia risk among a hospitalised stroke patient cohort: A case for increased vigilance in glucose monitoring

• Published in: Journal of clinical neuroscience 2014-02, Vol.21 (2), p.232-235
• Main Authors: Laird, E.A, Coates, V.E, Ryan, A.A, McCarron, M.O, Lyttle, D, McCrum-Gardner, E
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Blood Chemical Analysis; Blood Glucose - analysis; Brain Ischemia - blood; Brain Ischemia - complications; Diabetes; Diabetes Complications - blood; Female; Humans; Hypoglycemia - blood; Hypoglycemia - complications; Hypoglycemia - epidemiology; Inpatients; Intracranial Hemorrhages - blood; Intracranial Hemorrhages - complications; Intracranial Hemorrhages - epidemiology; Ischemic Attack, Transient - blood; Ischemic Attack, Transient - complications; Male; Management; Middle Aged; Neurology; Prevalence; Prevention; Retrospective Studies; Risk Factors; Stroke; Stroke - blood; Stroke - complications; Young Adult
• ISSN: 0967-5868; 1532-2653
• DOI: 10.1016/j.jocn.2013.03.031

Abstract We conducted a retrospective cohort study involving a review of the records of 112 patients consecutively admitted with acute stroke or transient ischaemic attack (TIA) to all three district general hospitals in one Health and Social Care Trust in Northern Ireland from 1 January to 15 April 2008. Glucose results for each of the first 5 days of hospital admission were ascertained. We compared interventions and clinical outcome between patients who experienced hypoglycaemia (glucose < 4.0 mmol/l) in the first 5 days, and patients with higher glucose results. Our results indicated that 11 (10%) patients experienced incidents of hypoglycaemia ranging from 1.8 to 3.9 mmol/l. None of the individuals affected had received intravenous or subcutaneous insulin. Only two of the hypoglycaemic episodes involved patients with a history of diabetes mellitus. Two patients experienced episodes of hypoglycaemia on 2 or more days. Six patients experienced hypoglycaemia at the lower threshold of glucose < 3.5 mmol/l and this was not associated with a history of diabetes. A history of diabetes mellitus prompted near patient glucose testing, but among patients without diagnosed diabetes, glycaemia was under-monitored. The test that most frequently indicated hypoglycaemia was a routine electrolyte profile tested in the hospital laboratory. Patients in the first 5 days after stroke have a small risk of hypoglycaemia. There is a need for greater vigilance in the monitoring of glucose among patients admitted to hospital with stroke or TIA.