SHM Converge Scientific Abstract ePoster Gallery-Stroke Outcomes From Stress-Induced Hyperglycemia in Diabetic Versus Non-Diabetic Patients

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This retrospective study examined 576 patients with acute ischemic stroke due to large-vessel occlusion who underwent endovascular treatment between March 2019 and June 2022. Patients were divided by pre-existing diabetes status: 230 had diabetes and 346 did not. The study asked whether stress-induced hyperglycemia, measured by the fasting glucose-to-glycated hemoglobin ratio (GAR), predicted poor 3-month outcome after EVT differently in diabetic and non-diabetic patients.<br /><br />Patients were stratified into four GAR quartiles. Functional outcome was assessed using the modified Rankin Scale at 3 months, with mRS > 2 defined as poor prognosis. The analysis used multivariable logistic regression to test whether GAR quartiles were independently associated with outcome.<br /><br />Overall, diabetic patients had higher GAR values and a higher rate of poor outcome than non-diabetic patients. In both groups, worse outcomes were more common as GAR increased. Higher GAR was also associated with more severe stroke, higher discharge NIHSS scores, more malignant edema, more symptomatic intracranial hemorrhage, and higher short-term mortality.<br /><br />However, the key finding was that stress-induced hyperglycemia was not an independent predictor of poor prognosis in the diabetic group after adjustment. In contrast, the highest GAR quartile was independently associated with worse 3-month outcome in the overall analysis, with the effect appearing stronger in non-diabetic patients.<br /><br />The authors conclude that premorbid diabetes status influences stroke outcomes after EVT, but stress-induced hyperglycemia alone does not explain the poor prognosis seen in diabetic patients. They suggest this may reflect chronic damage from long-term hyperglycemia or altered metabolic responses in diabetes.

Asset Subtitle

Ho Jun Yun

Meta Tag

Author List Gary Rajah, Ho Jun Yun, Honglian Duan, Lipeng Cai, Xiaokun Geng, Yanna Tong, Yuchuan Ding, Zhe Cheng

Category Research

Concept Acute Ischemic Stroke

Concept Glycemia-Associated Ratio

Concept Stress-Induced Hyperglycemia

Concept Endovascular Treatment

Concept Diabetes Mellitus

Distinguished Non-Finalist

Presenter Organization Wayne State University School of Medicine

Presenting Author Ho Jun Yun

Track Outcomes Research

Keywords

acute ischemic stroke

large-vessel occlusion

endovascular treatment

stress-induced hyperglycemia

glucose-to-glycated hemoglobin ratio

diabetes mellitus

modified Rankin Scale

poor prognosis

multivariable logistic regression

stroke outcome

Acute Ischemic Stroke

Glycemia-Associated Ratio

Stress-Induced Hyperglycemia

Endovascular Treatment

Diabetes Mellitus