Persistence and predictors of abnormal glucose metabolisms in patients after acute stroke.

摘要

OBJECTIVES: To determine the persistence of newly recognized abnormal glucose metabolism in patients following acute ischemic stroke and delineate the possible predictive factors for this persistence. METHODS: A prospective observational study was performed. One hundred and twenty-three patients with acute first-ever ischemic stroke and no previous diagnosis of diabetes mellitus were enrolled consecutively. Information from baseline and laboratory tests was recorded. A standard oral glucose tolerance test was performed on the fourteenth day after onset and 3 months later, respectively. RESULTS: One hundred and seven patients completed the study. Thirty-nine patients (36.3%) were diagnosed as having newly recognized diabetes on the 14th day and 28 patients (26.1%) after 3 months. Among the patients diagnosed as having diabetes or impaired glucose tolerance during hospitalization, 68.6% remained to present with abnormal glucose metabolism 3 months later. Lower post-load plasma glucose on the fourteenth day was detected as a predictor for aggravated glucose metabolism after 3 months of onset. CONCLUSION: Majority of newly recognized abnormal glucose metabolism during hospitalization persisted 3 months later. Patients with lower post-load glucose level on the fourteenth day had higher risk for aggravated glucose metabolism 3 months later. Those with higher fasting glucose concentration on admission or higher 2 hour post-load plasma glucose on the fourteenth day had significantly high risk for diabetes after 3 months.