Glycemic Control in Hospitalized Stroke Patients: A Review

Curr Diab Rep. 2021 Dec 1;21(11):48. doi: 10.1007/s11892-021-01416-1.

Abstract

Purpose of review: The purpose of this review is to discuss clinical trials involving glycemic control in hospitalized stroke patients and to review oral medications used in glycemic control. GLP-1 agonists, which have some preliminary studies in ischemic stroke, will also be reviewed.

Recent findings: Until recently, glycemic control targets in hospitalized stroke patients remained unclear. The SHINE (Stroke Hyperglycemia Insulin Network Effort) trial demonstrated no significant difference between aggressive versus standard of care glycemic control in the acute ischemic stroke patient. Although SHINE demonstrated a lack of statistical difference in glycemic control targets, many questions remain including glycemic control in patients with other stroke types (SAH, ICH). The role of non-insulin-based medications in glycemic control for hospitalized stroke patients remains unclear and presents an opportunity for further research. Finally, GLP-1 agonists present an interesting area of research for acute ischemic stroke.

Keywords: GLP-1 agonists; Glycemic control; SHINE trial; Stroke.

Publication types

  • Review

MeSH terms

  • Blood Glucose
  • Brain Ischemia*
  • Glycemic Control
  • Humans
  • Hyperglycemia* / drug therapy
  • Hypoglycemic Agents / therapeutic use
  • Insulin
  • Stroke* / drug therapy

Substances

  • Blood Glucose
  • Hypoglycemic Agents
  • Insulin