Recomendaciones para el adecuado control glucémico durante el ingreso después de un accidente vascular cerebral

Hyperglycemia in the acute phase of stroke is a common problem. When present it's associated with a poor outcome of patients with both ischemic and hemorrhagic stroke, and equally in diabetic and non-diabetic patients. High levels of plasma glucose are associated with the infarct volume growth, higher rates of disability and increased mortality. In addition, hyperglycemia decreases effectiveness of intravenous fibrinolysis, resulting in lower rates of recanalization, and increasing its most feared complication, the hemorrhagic transformation. So far, randomized clinical studies aimed at lowering glycemia in the acute phase of stroke have not demonstrated clinical benefits. Currently, we recommend monitoring of blood glucose during hospitalization to achieve normoglycemic levels, avoiding elevations higher than 155 mg/dL, a cut-off point beyond complications may occur.