value of estimation of serum glucose, glycosylated hemoglobin and cortisol in cerebrovascular stroke patients

ABSTRACT

This study includes 40 patients with acute cerebrovascular stroke [CVS], within 24 hours of their onsets. Twenty four patients were males and 16 were females. Their ages ranged from 25-90 years with a mean +/- SD of 57.8 +/- 12.2 years. Twenty "age and sex" matched healthy subjects were selected as a control group. The patients were followed up for 2 weeks, during their hospitalization and their conditions on discharge were graded as good-fair or poor. There was a significant increase in the admission blood glucose level, glycosylated haemoglobin [HbA1c], serum cortisol and total leucocytic count in patients with CVS compared to the control group [P < 0.001]. But there was no difference of any significance in all the studied parameters related to the sex of patients. CVS occurred predominantly among males with cigarette smoking [60%], hypertension [62.5%], old myocardial infarction [15%] and uncontrolled diabetics [50%]. There was a significant [P < 0.005 and 0.001] rise in the mean age, blood glucose level and serum cortisol in patients with severe clinical disablity compared with mild disability. No significant difference could be detected in blood glucose, or neurologic out come between diabetic and non diabetic patients. The percentage of poor prognosis was higher among diabetics [80%] compared to non diabetics [70%], in hypertensive [84%] compared to normotensives [66.7%] but these differences are not statistically significant. A significant increase in poor neurologic outcome was found among comatosed patients compared to fully conscious patients [P < 0.001], in older age group than younger one [P < 0.001], patients with high admission blood glucose level, high serum cortisol level, and severe cases with high total leucocytic count [P < 0.05, < 0.001, < 0.01 respectively]. Determination of HbA1c is important to identify diabetic patients from hyperglycemia as a response to stress