Correlation between blood glucose variability and poor prognosis in diabetic patients with acute stroke / 中国糖尿病杂志

ABSTRACT

Objective To investigate the correlation between blood glucose variability and poor prognosis in diabetes patients with acute stroke. Methods A total of 1 5 5 diabetes patients with acute stroke were divided into glucose variability group(n= 92,GluSD≥1. 4 mmol/L)and non-glucose variability group(n= 63,GluSD<1. 4 mmol/L)according to the GluSD levels. Then,the subjects in glucose variability group were divided into three subgroups according to GluSD levelsthe lowest tertile group (GluSD 1. 42~1. 87 mmol/L),the middle tertile group(GluSD 1. 43~2. 32 mmol/L)and the highest tertile group(GluSD 2. 33~2. 87 mmol/L). All patients accepted 72 h CGM after admission. NIHSS score, MoCA scale and Barthel index were used to assess short-term prognosis. Non-conditional logistic regression analysis was used to analyze the risk factors for poor prognosis. Results The levels of FPG [(8. 49± 1. 71 )vs (7. 33 ± 1. 58 )mmol/L],HbA1 c [(8. 61 ± 0. 55 )% vs (7. 14 ± 0. 43 )%]GluAve, GluMAGE,GluGLI and GluCV were higher in glucose variability group than in non-glucose variability group(P<0. 05 or P<0. 01 ). GluAve,GluMAGE,GluGLI and GluCV were higher in the highest tertile group than in the lowest tertile group (P<0. 05 ). With the increase of GluSD level,NIHSS score increased,MoCA score and Barthel index reduced (P<0. 05 ). Multivariate logistic regression analysis showed that age,HbA1 c,GluAve,GluCV and NIHSS score were risk factors for poor prognosis(P<0. 05 or P<0. 01). Conclusion Blood glucose variability is related to poor prognosis in diabetes patients with acute stroke,suggesting that reducing blood glucose fluctuations may be more beneficial to improve outcomes in the treatment of hypoglycemia.