HbA1c May Predict Outcome in Patients With Type 2 Diabetes Admitted for Acute Stroke

Blood sample for HbA1c test, diabetes diagnosis
A team of investigators sought to identify the impact of hyperglycemia on the severity of and outcomes associated with stroke in patients with type 2 diabetes.

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By estimating glycated hemoglogin (HbA1c) levels, clinicians may be able to better predict neurologic impairment and outcome among individuals with type 2 diabetes (T2D) admitted for acute stroke, according to study results presented at the 30th Annual Scientific and Clinical Congress of the American Association of Clinical Endocrinologists (ENVISION 2021).

This observational, descriptive, cross-sectional study included 55 individuals (aged 20-65 years) with new-onset stroke and either a diagnosis of diabetes or HbA1c levels >6.5%.  Investigation reports and radiologic findings were collected using Performa. HbA1c level was estimated following confirmation of stroke, with stroke severity assessed on days 1, 4, and 28 of hospitalization using the NIH Stroke Scale/Score (NIHSS). Outcome assessment took place on days 4 and 28. Spearman’s correlation was used to examine the relationship between HbA1c and NIHSS.

There was a significant association between HbA1c level and NIHSS on days 1, 4, and 28 (P =.001); individuals with HbA1c <7% experienced stroke that was mild to moderate, those with HbA1c ranging from 7% to 9% experienced moderate to severe stroke, and those with HbA1c >9% experienced severe stroke. There was a strong positive association between HbA1c levels and NIHSS (Spearman’s r, 0.760). Death occurred only among the 4 individuals with HbA1c >9. The relationship between HbA1c and mortality was significant (P =.001).

The study researchers concluded that “[estimation] of HbA1c levels on admission might be a predictor of the severity of neurological impairment as well as outcome in patients with [T2D] developing acute stroke.”

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Srivastava S, Chopra MK, Malode A, Kalwaan V, Bhamu RK, Kumar V. Study of association of hyperglycemia with acute stroke. Presented at: 2021 AACE Virtual Annual Meeting, May 26-29, 2021.