Q. Why is it important to measure glucose after an acute stroke? Answer each of the Yes/No questions below:
Bob’s capillary blood glucose (CBG/BM) was 10.8 mmol/l.
Q. Why is it important to measure glucose after an acute stroke? Answer each of the Yes/No questions below (correct answer in bold):
1. Increased glucose leads to poor functional outcomes:
Yes – Correct, Raised Glucose levels are associated with poor outcomes, increased mortality/morbidity and reduced functional outcomes. There is theoretical and animal evidence of increased stroke damage in the presence of hyperglycaemia.
No – Wrong, Raised Glucose levels are associated with poor outcomes, increased mortality/morbidity and reduced functional outcomes. There is theoretical and animal evidence of increased stroke damage in the presence of hyperglycaemia.
2. There is unequivocal evidence for setting up a sliding scale:
No – Correct, Intensive glucose control is not recommended where acute stroke is complicated by hyperglycaemia, therefore intervention may only be required when blood glucose is very high (>15 mmol/L). The management of stroke patients with established diabetes should follow established protocols.
Yes – Wrong, Intensive glucose control is not recommended where acute stroke is complicated by hyperglycaemia, therefore intervention may only be required when blood glucose is very high (>15 mmol/L). The management of stroke patients with established diabetes should follow established protocols.
3. Increased glucose leads to reduced immunity to infection. The latter is common after acute stroke:
Yes – Correct, increased glucose leads to reduced ability to fight infection. It has been shown that glucose above about 15 mmol/l is associated with decreased immune cell function including impaired phagocytosis. Infection is very common during acute stroke.
No – wrong, increased glucose leads to reduced ability to fight infection. It has been shown that glucose above about 15 mmol/l is associated with decreased immune cell function including impaired phagocytosis. Infection is very common during acute stroke.
4. Increased glucose leads to increased risk of seizures:
Yes – Correct, seizures can be caused by very high or low blood glucose.
No- Wrong, seizures can be caused by very high or low blood glucose.
5. Blood glucose levels are likely to continue rising in the first few days after an acute stroke:
No – Correct, whilst there is an initial stress response with increased adrenaline leading to increased glucose in the first few hours, over subsequent days glucose tends to decrease again in the non-diabetic. Therefore interpretation of lab glucose concentrations after the first day is a more accurate indicator of diabetes or impaired glucose tolerance.
Yes- Wrong, whilst there is an initial stress response with increased adrenaline leading to increased glucose in the first few hours, over subsequent days glucose tends to decrease again in the non-diabetic. Therefore interpretation of lab glucose concentrations after the first day is a more accurate indicator of diabetes or impaired glucose tolerance.
Page last reviewed: 07 Dec 2021
