Prevalence and prediction of unrecognised diabetes mellitus and impaired glucose tolerance following acute stroke

• Published in: Age and ageing 2004-01, Vol.33 (1), p.71-77
• Main Authors: Gray, Christopher S., Scott, Jon F., French, Joyce M., Alberti, K. G. M. M., O’Connell, Janice E.
• Format: Article
• Language: English
• Subjects: Acute Disease; Adult; Aged; Aged, 80 and over; Care and treatment; Diabetes; Diabetes Complications; Diabetes mellitus; Diabetes Mellitus - epidemiology; elderly; Elderly people; Female; Glucose; Glucose Intolerance - complications; Glucose Intolerance - epidemiology; Glucose Tolerance Test; Glycated Hemoglobin A - analysis; Humans; Intolerance; Male; Middle Aged; oral glucose tolerance test; Predictive Value of Tests; Prevalence; Risk factors; Stroke; Stroke - complications; Strokes; Undiagnosed
• ISSN: 0002-0729; 1468-2834
• DOI: 10.1093/ageing/afh026

Background: diabetes mellitus not only increases the risk of ischaemic stroke two- to four-fold but also adversely inXuences prognosis. The prevalence of recognised diabetes mellitus in acute stroke patients is between 8 and 20%, but between 6 and 42% of patients may have undiagnosed diabetes mellitus before presentation. Post-stroke hyperglycaemia is frequent and of limited diagnostic value and the oral glucose tolerance test assumes that the patient is clinically stable and eating normally. There is a need for a simple and reliable method to predict new diabetes mellitus in acute stroke patients. Objectives: to determine the prevalence of unrecognised diabetes mellitus and impaired glucose tolerance on hospital admission and 12 weeks later in acute stroke patients with post-stroke hyperglycaemia ≥6.1 mmol/l. To measure the accuracy of hyperglycaemia and elevated glycosylated haemoglobin concentration in predicting the presence of unrecognised diabetes mellitus at 12 weeks. Design: acute (