Clinical Scorecard: Impact of Initial Hyperglycemia, In-Hospital Glycemic Control, and Discharge Results in Acute Ischemic Stroke: Findings from a Comprehensive Stroke Center in the UAE

At a Glance

Key Highlights

• Admission hyperglycemia (51.7%) associated with unfavorable discharge outcomes.
• Inappropriate management in 85.8% of hyperglycemic patients.
• Routine HbA1c testing identified occult diabetes in 18.4% of patients.
• No severe hypoglycemia occurred during the study.

Guideline-Based Recommendations

Diagnosis

• Admission capillary glucose level >7.8 mmol/L indicates hyperglycemia.

Management

• Treat hyperglycemia to a target of 7.8–10.0 mmol/L using subcutaneous insulin.

Monitoring & Follow-up

• Structured admission orders and q6h monitoring recommended.

Risks

• Intensive insulin protocols do not improve functional outcomes and increase severe hypoglycemia risk.

Patient & Prescribing Data

218 consecutive adults with acute ischemic stroke.

Adherence to SHINE trial-aligned management standards was low.

Clinical Best Practices

• Implement structured admission orders for glycemic management.
• Conduct routine HbA1c testing for undiagnosed diabetes.

Related Resources & Content

• American Heart Association/American Stroke Association Guidelines
• SHINE Trial