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Intense IV blood glucose control ‘doesn’t improve stroke outcomes’

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Intravenous insulin does not improve stroke outcomes compared to standard blood glucose control using insulin shots, according to researchers.

They said their findings answered a worldwide debate about the best way to control glucose in stroke patients.

“This study provides clear evidence to guide the control of glucose levels in patients experiencing acute ischemic stroke and hyperglycemia”

Karen Johnston

Hyperglycemia is common in patients with acute ischemic stroke and is associated with poor recovery, they noted.

The Stroke Hyperglycemia Insulin Network Effort (SHINE) study results were presented at the American Stroke Association’s International Stroke Conference 2019, in Honolulu.

It assessed the efficacy and safety of up to 72 hours of glucose control using continuous intravenous insulin infusion versus standard subcutaneous injections in 1,151 patients at 63 sites across the US.

According to the study authors, the primary findings showed no significant benefit from the intervention.

University of Virginia

Karen Johnston

Source: American Heart Association

Karen Johnston

Intense glucose therapy via IV insulin, which lowered glucose to a target of 80-130mg/dL, did not improve functional outcomes at 90 days.

This was compared to standard glucose control using insulin shots, which aimed to lower glucose below 180mg/dL.

In addition, intense glucose therapy increased the risk of hypoglycemia and required more resources, such as increased supervision from nursing staff, said the researchers.

“This study provides clear evidence to guide the control of glucose levels in patients experiencing acute ischemic stroke and hyperglycemia, or increased glucose,” said Professor Karen Johnston, from the University of Virginia in Charlottesville.

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