Insulin for glycaemic control in acute ischaemic stroke.

摘要: Background People with hyperglycaemia concomitant an acute stroke have greater mortality, severity, and functional impairment when compared those normoglycaemia at presentation. This is update of a Cochrane Review first published in 2011. Objectives To determine whether intensively monitoring insulin therapy aimed maintaining serum glucose within specific normal range (4 to 7.5 mmol/L) the 24 hours ischaemic influences outcome. Search methods We searched Stroke Group Trials Register (September 2013), CENTRAL (The Library 2013, Issue 8), MEDLINE (1950 September EMBASE (1980 CINAHL (1982 Science Citation Index (1900 Web (ISI Knowledge) (1993 2013). We also ongoing trials registers SCOPUS. Selection criteria Randomised controlled (RCTs) comparing monitored versus usual care adults stroke. Data collection analysis We obtained total 1565 titles through literature search. Two review authors independently selected included articles extracted study characteristics, quality, data estimate odds ratio (OR) 95% confidence interval (CI), mean difference (MD) standardised (SMD) outcome measures. resolved disagreements by discussion. Main results We 11 RCTs involving 1583 participants (791 intervention group 792 control group). found that there was no between treatment groups outcomes death or dependency (OR 0.99, CI 0.79 1.23) final neurological deficit (SMD -0.09, -0.19 0.01). The rate symptomatic hypoglycaemia higher 14.6, 6.6 32.2). In subgroup analyses diabetes mellitus (DM) non-DM, we for disability deficit. number needed treat not significant harm nine hypoglycaemia. Authors' conclusions After updating results our previous review, administration intravenous objective does provide benefit terms outcome, death, improvement significantly increased hypoglycaemic episodes. Specifically, people whose levels were maintained tighter experienced risk asymptomatic than group.