Annals of Rehabilitation Medicine

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"Hyperglycemia"

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Brain disorders

Post-stroke Hyperglycemia in Non-diabetic Ischemic Stroke is Related With Worse Functional Outcome: A Cohort Study: Jin A Yoon, Yong-Il Shin, Deog Young Kim, Min Kyun Sohn, Jongmin Lee, Sam-Gyu Lee, Yang-Soo Lee, Eun Young Han, Min Cheol Joo, Gyung-Jae Oh, Minsu Park, Won Hyuk Chang, Yun-Hee Kim; Ann Rehabil Med 2021;45(5):359-367. Published online October 31, 2021; DOI: https://doi.org/10.5535/arm.21124

Abstract
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Objective
To investigate long-term and serial functional outcomes in ischemic stroke patients without diabetes with post-stroke hyperglycemia.
Methods
The Korean Stroke Cohort for Functioning and Rehabilitation (KOSCO) is a large, multi-center, prospective cohort study of stroke patients admitted to participating hospitals in nine areas of Korea. From KOSCO, ischemic stroke patients without diabetes were recruited and divided into two groups: patients without diabetes without (n=779) and with post-stroke hyperglycemia (n=223). Post-stroke hyperglycemia was defined as a glucose level >8 mmol/L. Functional assessments were performed 7 days and 3, 6, and 12 months after stroke onset.
Results
There were no significant differences in baseline characteristics between the groups, except in the age of onset and smoking. Analysis of the linear correlation between the initial National Institutes of Health Stroke Scale (NIHSS) score and glucose level showed no significant difference. Among our functional assessments, NIHSS, Fugl-Meyer Assessment (affected side), Functional Ambulatory Category, modified Rankin Scale, and Korean Mini-Mental State Examination (K-MMSE) showed statistically significant improvements in each group. All functional improvements except K-MMSE were significantly higher in patients without post-stroke hyperglycemia at 7 days and 3, 6, and 12 months.
Conclusion
The glucose level of ischemic stroke patients without diabetes had no significant correlation with the initial NIHSS score. The long-term effects of stress hyperglycemia showed worse functional outcomes in ischemic stroke patients without diabetes with post-stroke hyperglycemia.

Citations

Citations to this article as recorded by

Impact of Stress‐Induced Hyperglycemia on In‐Hospital Medical Complications in Patients With Acute Stroke: From a Large‐Scale Nationwide Longitudinal Registry
Xintong Song, Yi Ju, Hongqiu Gu, Zhikai Zhu, Zixiao Li, Qian Zhang, Xingquan Zhao
Annals of Clinical and Translational Neurology.2026; 13(3): 466. CrossRef
Stroke and associated comorbidities in Southeast Asian countries
Aishika Datta, Soumya Akundi, Kaveri Wagh, Gangadhar Bhurle, Deepaneeta Sarmah, Arvind Sharma, Sudhir Shah, Anupom Borah, Shailendra Saraf, Pallab Bhattacharya
Neuroprotection.2025; 3(1): 29. CrossRef
Stroke in the Patient With Type 2 Diabetes
Terri W. Jerkins, David S.H. Bell
Endocrine Practice.2025; 31(4): 547. CrossRef
Autonomic dysfunction after stroke: an overview of recent clinical evidence and perspectives on therapeutic management
Anush Barkhudaryan, Wolfram Doehner, Nadja Jauert
Clinical Autonomic Research.2025; 35(4): 553. CrossRef
Stress Hyperglycemia as a Prognostic Indicator of the Clinical Outcomes in Patients with Stroke: A Comprehensive Literature Review
Majed Mohammad Alabdali, Abdulrahim Saleh Alrasheed, Fatimah Ahmed Alghirash, Taif Mansour Almaqboul, Ali Alhashim, Danah Tareq Aljaafari, Mustafa Ahmed Alqarni
Biomedicines.2025; 13(8): 1834. CrossRef
Neuroprotective Effects of SELFormer‐Selected β‐Citronellol and β‐Caryophyllene in Vagotomized Ischemic Stroke Model Through Direct Brain Protection and Gut Microbiota Modulation
Yu Yue, Chen Li, Ting Zhang, Sunmin Park
BioFactors.2025;[Epub] CrossRef
A comparative analysis of the cholesterol–high-density lipoprotein–glucose index and the triglyceride–glucose index in predicting in-hospital mortality in critically ill ischemic stroke patients
Huang Luwen, Li Linlin, Yu Ming, Xu Lei
Frontiers in Neurology.2025;[Epub] CrossRef
Association of stroke with possible sarcopenic obesity and the modified effect from healthy lifestyle: a cross-sectional study based on CHARLS
Jinhui Song, Danchan Lu, Li Zhang, Yong Wang, Yanfei Wu, Shuchang Zhong
BMC Public Health.2025;[Epub] CrossRef
High Glucose Aggravates Cerebral Ischemia/Reperfusion via Truncated NLRP3‐Mediated Hexokinase‐2 Translocation
Hengchang Zhang, Ruoyi Guo, Xiang Li, Yang Zhang, Lujun Zhou, Junjie Wang, Yudi Huang, Zengqiang Yuan, Lijuan Song, Yajin Liao
CNS Neuroscience & Therapeutics.2025;[Epub] CrossRef
Serum Lipid Profiles as Predictors of Hemorrhagic Transformation After Thrombolysis in Acute Cerebral Infarction: A Prospective Study
Dongxia Cheng, Huawen Fu, Ziqi Zhou, Xiaofeng Li
Current Neurovascular Research.2025; 22(3): 215. CrossRef
Stress hyperglycemia increases short-term mortality in acute ischemic stroke patients after mechanical thrombectomy
Bing Yang, Xuefang Chen, Fangze Li, Junrun Zhang, Dawei Dong, Huiyue Ou, Longyan Lu, Niu He, Xiaohong Xu, Xiufeng Xin, Jingchong Lu, Min Guan, Hongyu Qiao, Anding Xu, Huili Zhu
Diabetology & Metabolic Syndrome.2024;[Epub] CrossRef
Implications of fasting plasma glucose variability on the risk of incident peripheral artery disease in a population without diabetes: a nationwide population-based cohort study
Hye Soo Chung, Soon Young Hwang, Jung A. Kim, Eun Roh, Hye Jin Yoo, Sei Hyun Baik, Nan Hee Kim, Ji A. Seo, Sin Gon Kim, Nam Hoon Kim, Kyung Mook Choi
Cardiovascular Diabetology.2022;[Epub] CrossRef
The Role of Nondiabetic Hyperglycemia in Critically Ill Patients with Acute Ischemic Stroke
Hung-Sheng Shih, Wei-Sheng Wang, Li-Yu Yang, Shu-Hao Chang, Po-Huang Chen, Hong-Jie Jhou
Journal of Clinical Medicine.2022; 11(17): 5116. CrossRef
A Path to Precision Medicine: Incorporating Blood-Based Biomarkers in Stroke Rehabilitation
Byung-Mo Oh
Annals of Rehabilitation Medicine.2021; 45(5): 341. CrossRef

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The Effect of Hyperglycemia at Admission on Clinical Outcomes after Acute Stroke.: Oh, Sang Hyang , Hyun, Hwa Jin , Lee, Young Jin , Nam, Seung Ho , Yoon, Jong Myung , Bok, Soo Kyung; J Korean Acad Rehabil Med 2007;31(6):642-648.

Abstract
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Objective
To clarify the issues about the importance of hyperglycemia in the acute stage of stroke as a poor predictor of clinical outcome, we analyzed the relationship between the glucose level in admission and clinical outcome in the acute stroke patients. Method: Twenty-five patients with sudden onset of acute stroke with focal neurological deficit were included in this study. Clinical assessments consisted of the National Institutes of Health Stroke Scale (NIHSS) for neurological impairment and the Korean modified Bathel index (KMBI) for functional status. NIHSS and K-MBI were assessed at admission and at discharge. Plasma glucose level was measured at admission in all patients. Acute hyperglycemia at admission was defined as fasting plasma glucose level more than 140 mg/dl. Statistical analysis were used to compare variables and clinical outcome scores between the normoglycemic and hyperglycemic groups. Results: For the patient with hyperglycemia at admission, the odds ratio for neurological improvement decreased (Ղ=-0.604) and the odds ratio for functional improvement decreased (Ղ=-0.553). However, control of the glucose level during the acute stroke was not significantly related to neurological and functional recovery (p＞0.05).Conclusion: In patients with acute stroke, hyperglycemia at admission was associated with neurological and functional impairments. Therefore, we expect that strict control of hyperglycemia during the acute stroke would improve clinical outcomes. (J Korean Acad Rehab Med 2007; 31: 642-648)

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The Relationship between Hyperglycemia and Neurologic, Functional Outcome with Traumatic Brain Injury.: Choi, Seung Ho , Yoon, Joon Shik , Kim, Chang Hwan; J Korean Acad Rehabil Med 2001;25(4):572-578.

Abstract
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Objective: Traumatic brain injury is related to the acute stress response, and this can be accompanied by an elevated serum glucose level. So we estimated the influence of hyperglycemia on neurologic, functional status and outcome.

Method: We studied the 139 traumatic brain injured patients who had been admitted to the department of neurosurgery from 1996 to 2000, retrospectively. We reviewed initial serum glucose level, postoperative glucose level, and Glasgow Coma Scale (GCS), Glasgow Outcome Scale (GOS). We compared these values with functional independence measure (FIM) scores. Patients were divided into two groups according to the initial serum glucose level, then we analyzed the correlation between glucose level and GCS, GOS, FIM.

Results: The correlations of early hyperglycemia with GCS, GOS, initial FIM scores were significant (p＜0.01). But serum glucose levels were not correlated with plateau FIM scores (p＞0.05). Patients with unfavorable neurologic outcome after 10 days from head injury had significantly high serum initial and postoperative glucose levels than those with favorable neurologic outcome (p＜0.01).

Conclusion: In patients who had received rehabilitation therapy with moderate or severe head injury, early hyperglycemia were significantly correlated with initial FIM scores, GCS, GOS, but not with the plateau FIM scores.