Hiperglicemia post-ictus

OBJECTIVES: To review the available evidence about frequency and mechanisms of post-stroke hyperglycemia (PSH), and those relate PSH with the risk of unfavorable prognosis and efficacy of different treatment for PSH. DEVELOPMENT: Between 43% and 68% of patients who suffer stroke have an increase in glycaemia levels in acute state, between 16% and 24% were not know as diabetics. Most of they have abnormal regulation glucose, 16.4% received new diagnostic as diabetic, and 23.1% have an alter glucose tolerance test. PSH have two sharp points: one at first eight hours and other between third and fifth day. PSH was associated to dead and unfavorable prognosis, especially persistent PSH. Moreover, PSH increase risk of hemorrhagic transformation of stroke with thrombolytic treatment. Cut point for begin with insulin therapy in unclear, some studies support 7.2 mmol/L, or 8.7 mmol/L, nevertheless guidelines suggest 10 mmol/L due the risk of hypoglycemia with more aggressive treatments.