Clinical Knowledge Question Results

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Question: Which of the following is an appropriate upper limit for target blood glucose in the setting of hospitalization for an acute ischemic stroke?

20% of
Medical Professionals
Chose A

 

27% of
Medical Professionals
Chose B

 

23% of
Medical Professionals
Chose C

30% of
Medical Professionals
Chose D


Answer: D. Hyperglycemia is associated with poor outcomes after acute ischemic stroke, but trials have suggested that tight glucose control with intravenous insulin is not beneficial and might be harmful. A multicenter trial of over 1100 acute stroke patients found that insulin infusion therapy with a target glucose of 80 to 130 mg/dL did not improve 90-day functional outcomes compared with subcutaneous insulin on a sliding scale with a target glucose of 80 to 179 mg/dL.

The American Heart Association/American Stroke Association guidelines for acute ischemic stroke recommend treatment for hyperglycemia to achieve serum glucose concentrations in the range of 140 to 180 mg/dL (7.8 to 10 mmol/L) [1]. The European Stroke Initiative guidelines recommend treatment for glucose >180 mg/dL (>10 mmol/L).
 

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