Association of Glycated Hemoglobin With Acute Ischemic Stroke- A Hospital Based Observational Study

Background- Tight glucose control (TGC) improves clinical outcomes in critically ill non-stroke patients. However, ICU investigations on rigorous glucose control does not conrm these promising benets. In some trials, TGC increased the risk of hypoglycaemia and was associated with poor clinical outcomes. The latest ndings are being used to discuss TGC's efcacy and safety. Ischemic stroke patients with hyperglycaemia can improve their prognosis with TGC. However, safely delivering TGC to severely ill individuals seems tricky. This study examined the relationship between HbA1c and acute ischemic stroke. HbA1c was estimated at admission to assess glycaemic status and to investigate its prognostic signicance in Acute Ischemic Stroke by connecting it with outcome. Methods- This was an observational study undertaken from March 2021 to December 2022 in the Department of Medicine at a Maharashtra tertiary care hospital in central India. 100 acute ischemic stroke patients meeting inclusion and exclusion criteria gave written and informed consent. Clinical and radiological examinations revealed acute ischemic stroke. Regular haematology tests were done. HbA1c was taken for all patients. The NIHSS criteria determined stroke severity. The severity was measured on Days 0, 3, and 7. The Modied Rankin Scale examined stroke outcome. Data was examined with SPSS-25. Results- There was male preponderance with 72% of the study participants being males. The mean age was 57.86 ± 13.95 years. A total of 31 study participants were diabetic. When assessed according to the NIHSS score, it was observed that the mean score for 100 cases on Day 0 was 11.20 ± 3.87; range: 4.00 to 26.00. Most of the cases had MRS score of 3 to 5 (74%), followed by 0 to 2 (15%) and 6 (11%). HbA1c showed signicant weakly positive correlation with NIHSS score at Day 0, Day 3 and Day 7 (P value < 0.001). When assessed for MRS score and HbA1c, HbA1c showed a signicant weakly positive correlation with the MRS score. (P value < 0.001) ConclusionThe severity of the score (as assessed by the NIHSS score) and the outcome (as assessed by the MRS score) have a signicantly positive correlation with HbA1c. Also, assessing according to the known history of diabetes, the outcome is poorer in diabetics as compared to non-diabetics. Thus, chronic hyperglycemia may also be a risk factor for poorer outcome following acute ischemic stroke.