The Role of HbA1c Determination in Detecting Unknown Glucose Disturbances in Ischemic Stroke
Roquer, Jaume (Universitat Pompeu Fabra. Departament de Ciències Experimentals i de la Salut)
Rodríguez-Campello, Ana (Universitat Autònoma de Barcelona. Departament de Medicina)
Cuadrado-Godia, Elisa (Universitat Pompeu Fabra. Departament de Ciències Experimentals i de la Salut)
Giralt Steinhauer, Eva (Institut Hospital del Mar d'Investigacions Mèdiques)
Jimenez-Conde, Jordi (Institut Hospital del Mar d'Investigacions Mèdiques)
Soriano, Carol (Institut Hospital del Mar d'Investigacions Mèdiques)
Ois, Angel (Institut Hospital del Mar d'Investigacions Mèdiques)

Data:	2014
Resum:	To evaluate the usefulness of hemoglobin A1c (HbA1c) determinations during the acute ischemic stroke (IS) to identify undiagnosed glucose disturbances in a prospective series of patients with first-ever IS. Retrospective analysis of a prospective series of first-ever IS patients. Patients with previous diagnosis of diabetes mellitus (DM) were excluded from the study. Patients were classified as non-DM (HbA1c<5. 7% and no previous evidence of 2 or more fasting blood glucose> = 126 mg/dL), prediabetes (HbA1c from 5. 7% to 6. 4%), and new suspected DM (HbA1c> = 6. 5% independently of current blood glucose). Medical charts from hospital discharge to July 2014 of all suspected DM patients were reviewed to confirm the DM diagnosis. The initial cohort included 1283 patients, of which 393 were excluded because of previous DM diagnosis and 136 because HbA1c during acute stroke phase was not available. No demographic differences were observed between patients with and without HbA1c determinations. The final cohort was composed of 754 patients with first-ever IS and unknown DM history. HbA1c determination suggested new DM in 87 cases (11. 5%) and detected 273 patients with prediabetes (36. 2%). New DM cases were identified in all etiological stroke subtypes. After discharge, DM diagnosis was confirmed in 80. 2% of patients with available follow-up. HbA1c determination detected both undiagnosed DM and prediabetes in IS patients without taking into account the blood glucose values during admission, and independently of etiological stroke subtype. HbA1c determination should be included in the systematic screening of all IS patients.
Ajuts:	Instituto de Salud Carlos III RD12/0042/0020
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Publicat a:	PloS one, Vol. 9 (december 2014) , ISSN 1932-6203

DOI: 10.1371/journal.pone.0109960
PMID: 25485761

12 p, 264.4 KB

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