Abstract

Diabetes mellitus by virtue of its association with micro vascular and macrovascular disease is an important risk factor in the genesis of stroke. Stroke is Twice more common in diabetics than in non diabetics. Objective of the present study was to measure the random blood glucose level in the early phase of ischemic stroke in both diabetics and in non diabetics and to evaluate the severity and prognosis in both diabetics and non diabetics in relation to hyperglycemia. Material and Methods: Total of 120 of acute ischemic stroke patients admitted in the Institute of emergency medicine medical college & hospital were studied. Blood pressure measurement, blood sugar, urea, creatinine, electrolytes, hemoglobin, total count, differential count; urine sugar, albumin, deposits; electrocardiogram and chest X ray done for all patients. The severity of stroke for each patient is calculated based on NIH stroke scale. In patients with blood sugar more than 6.1 mmol/l (110 mg/dl) and without a history of diabetes, Hemoglobin A 1c was performed. The patients were followed up for thirty days and outcome in the form of death; poor, moderate and good improvements were recorded Results: Among the 120 patients 64 had hypertension, 68 had diabetes, 58 had hypercholesterolemia, 6 had previous history of myocardial infarction and 2 female patients had atrial fibrillation. Hyperglycemic patients had a higher score when compared to Euglycemic patients, which was statistically significant. Among the admission day uncontrolled diabetes patients had the highest mean NIHSS. A positive correlation (r=0.71) between admission day sugar value and the outcome of stroke. Higher admission day elevated blood glucose level has increased mortality and high risk of poor functional recovery was seen in the results of the study. Conclusion: There is a good correlation between admission day glucose level and the outcome in ischemic stroke. Admission day elevated glucose level was a significant predictor of mortality and poor functional outcome after acute stroke. Hence, restoration of normoglycemia as soon as possible should be encouraged.

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