Trial reportAnnals of neurology2010
Randomized, controlled trial of insulin for acute poststroke hyperglycemia.
Trial report in Annals of neurology, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 70 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
70 citing papers in PubMed, 4 syntheses or guidelines pooled it, 147 citations in OpenAlex.
- Effects of Diabetes Mellitus and Admission Glucose in Patients Receiving Mechanical Thrombectomy: A Systematic Review and Meta-analysis.Neurocritical care · 2018Pooled it
- Insulin for glycaemic control in acute ischaemic stroke.The Cochrane database of systematic reviews · 2014Pooled it
- Optimal glycemic control in neurocritical care patients: a systematic review and meta-analysis.Critical care (London, England) · 2012Pooled it
- Hyperglycaemia and infarct size in animal models of middle cerebral artery occlusion: systematic review and meta-analysis.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2011Pooled it
- A randomized trial to investigate the efficacy and safety of insulin glargine in hyperglycemic acute stroke patients receiving intensive care.Scientific reports · 2021Trial
- Trial
- Elevated Fasting Blood Glucose Is Predictive of Poor Outcome in Non-Diabetic Stroke Patients: A Sub-Group Analysis of SMART.PloS one · 2016Trial
- Trial
- Impact of Glycemic Trajectory and Variability on Ischemic Stroke Prognosis and Exploration of Its Mechanisms: A Comprehensive Review.Healthcare (Basel, Switzerland) · 2026Review
- Impact of admission hyperglycemia on clinical outcomes in patients with acute large ischemic stroke undergoing endovascular treatment.Diabetology & metabolic syndrome · 2026Article
- Association between acute-phase glycaemic metrics and stroke-associated pneumonia in patients with acute ischaemic stroke.BMJ neurology open · 2026Article
- Predictors and outcomes of angioplasty and stenting in acute intracranial atherosclerosis-related vertebrobasilar artery occlusion.Frontiers in neurology · 2025Article
- A Nomogram Incorporating Intracranial Atherosclerosis Score for Predicting Early Neurological Deterioration in Minor Stroke Patients With Type 2 Diabetes Mellitus.Diabetes, metabolic syndrome and obesity : targets and therapy · 2025Article
- Admission hyperglycemia effect on symptomatic intracranial hemorrhage in tenecteplase versus alteplase before large vessel occlusion stroke thrombectomy.Journal of neurology · 2024Article
- What is the impact of acute endocrine and metabolic alterations on long-term ischemic stroke prognosis: a prospective study.BMC geriatrics · 2024Article
- Impact of neutrophil-to-lymphocyte ratio on the effect of hyperglycemia at admission on clinical outcomes after endovascular thrombectomy.Neuroprotection (Chichester, England) · 2024Article
- Higher blood glucose is associated with the severity of hemorrhagic transformation after endovascular therapy for stroke.Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association · 2024Observational
- Association between stress hyperglycemia ratio with short-term and long-term mortality in critically ill patients with ischemic stroke.Acta diabetologica · 2024Article
- Postoperative blood glucose increase is associated with futile recanalization in patients with successful thrombectomy: a retrospective study.BMC neurology · 2023Article
- Skin capillary amylin deposition resembles brain amylin vasculopathy in rats.Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association · 2023Article
10 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
- Commented on by
Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivePoststroke hyperglycemia is common and is associated with increased risk of death and dependence, but appropriate management remains uncertain. Glucose potassium insulin (GKI) infusion did not benefit patients with moderate poststroke hyperglycemia in a recent trial. Using magnetic resonance imaging (MRI), previous studies identified a relationship between recruitment of ischemic tissue to the final infarct and hyperglycemia, possibly mediated by brain lactic acidosis.
methodsWe undertook a randomized, placebo-controlled trial of GKI infusion in patients with blood glucose >126mg/dl (7mmol/l) within 24 hours of ischemic stroke. The primary endpoint was infarct growth on MRI between baseline and day 7. Brain lactate concentrations were measured with magnetic resonance spectroscopy.
resultsForty patients were randomized, 15 to saline and 25 to GKI infusions of different durations. Capillary blood glucose concentrations were lowered significantly from 6 to 12 hours after GKI initiation. There was no significant difference on any measure of infarct growth between the GKI and saline groups. In a secondary analysis, GKI was associated with significantly greater infarct growth in patients with complete intracranial vessel occlusion compared with controls (p = 0.011 for group-vessel status interaction). Brain lactate levels increased in control subjects, but were significantly lower with GKI infusion. Predominantly asymptomatic hypoglycemia occurred in 76% of GKI-treated subjects.
interpretationGKI infusion within 24 hours of stroke lowered blood glucose and attenuated an increase in brain lactate, but did not affect cerebral infarct growth. Exploratory analysis found that GKI infusion was associated with greater infarct growth in patients with persistent arterial occlusion, and with a high incidence of asymptomatic hypoglycemia.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.