Glucose metabolism following stroke in people without diabetes — ASN Events
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Glucose metabolism following stroke in people without diabetes (#268)

Karen Borschmann 1 2 , Elif Ekinci 3 , Sandra Iuliano-Burns 3 , Marco YC Pang 4 , Julie Bernhardt 1 2
  1. Stroke Division, Florey Neuroscience Institutes, Heidelberg, VIC, Australia
  2. School of Physiotherapy, LaTrobe University, Bundoora, VIC, Australia
  3. Department of Endocrinology, University of Melbourne, Heidelberg Heights, VIC, Australia
  4. Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hung Hom, Hong Kong

Background: One-third of stroke patients develop hyperglycaemia soon after hospitalisation. Of these patients, up to two-thirds experience impaired glucose tolerance (IGT), impaired fasting glucose (IFG) or diabetes by three months after stroke1 . Muscle loss and immobility after stroke may contribute to development of IFG and IGT.
Aims: To investigate the glucose metabolism of physically impaired patients following stroke, in a prospective observational study.
Methods: Participants without previous diagnosis of diabetes who were medically stable but unable to walk within one week of hemispheric stroke were recruited from Austin Health. Outcomes were assessed within two weeks of stroke: total body muscle mass assessed by dual-x-ray absorptiometry (DXA), OGTT (oral glucose tolerance test) and HbA1c.
Results: Twenty-eight participants were recruited, aged 69.4 years (IQR 62.4 to 78.3), 10 (35.7%) females. Body mass index was 27.1 kg/m2 (95% CI 25.1 to 29.2). Waist to hip ratio was 0.99 (95%CI 0.92 to 1.07, n=19). Total muscle mass was 55.4 kg (95%CI 47.2 to 62.9), which was 77.8% of total body weight. Fasting plasma glucose (FPG) was 5.9 mmol/L (95%CI 5.3 to 6.1, n=28), assessed 1.75 days post admission. IFG was present in 13 (46.4%) participants. HbA1c, assessed at 5.7 days, was <5.7% in seven (25.9%) participants and was 5.7-6.4% in 20 participants (74.1%). OGTT was performed in 18 participants (64.3%), nine were unable due to dysphagia and one declined the test. OGTT results indicated that 10 (35.7%) participants had normal glucose tolerance, 6 (21.4%) had IGT, one (3.6%) had IFG and two (7.1%) had diabetes.
Conclusion: Impaired glucose tolerance and impaired fasting glucose emerge soon after stroke. Changes in body composition, muscle function and physical activity continue to be monitored in this ongoing study and may help elucidate the basis for these metabolic changes.

  1. Gray, C., et al., Prevalence and prediction of unrecognised diabetes mellitus and impaired glucose tolerance following acute stroke. Age and Ageing, 2004. 33(1): p. 71-77.