A randomized trial to investigate the efficacy and safety of insulin glargine in hyperglycemic acute stroke patients receiving intensive care
Journal
Scientific Reports
Journal Volume
11
Journal Issue
1
Pages
11523
Date Issued
2021
Abstract
This pilot, randomized, open-label controlled study compared the basal–bolus regimens of insulin glargine (IG) and neutral protamine Hagedorn (NPH) insulin in stroke patients with hyperglycemia receiving intensive care. The study recruited acute stroke patients requiring intensive care within 72?h (h) of onset and had blood glucose > 200?mg/dL. 50 patients received IG (n = 26) or NPH (n = 24) with added short-acting prandial regular insulin over a 72-h period. The primary end point was the percentage of glucose within 80–180?mg/dL assessed through continuous glucose monitoring. The baseline characteristics were comparable, except the IG had higher glucose pre-randomization than the NPH (290.69 ± 82.31 vs. 246.04 ± 41.76?mg/dL, P = 0.021). The percentage of time with glucose between 80 and 180?mg/dL was 45.88 ± 27.04% in the IG and 53.56 ± 22.89% in the NPH (P = 0.341) and the percentage of glucose reduction was 31.47 ± 17.52% in the IG and 27.28 ± 14.56% in the NPH (P = 0.374). The percentage of time with glucose < 60?mg/dL was 0.14 ± 0.49% in the IG and 0.47 ± 1.74% in the NPH. Poststroke outcomes were not significantly different. In conclusion, IG is safe and equally effective as an NPH-based basal-bolus regimen for acute stroke patients with hyperglycemia receiving intensive care. Trial registration ClinicalTrials.gov, NCT02607943. Registered 18/11/2015, https://clinicaltrials.gov/ct2/show/NCT02607943. ? 2021, The Author(s).
SDGs
Other Subjects
insulin glargine; acute disease; aged; blood; cerebrovascular accident; complication; controlled study; female; glucose blood level; human; hypoglycemia; intensive care; male; metabolism; middle aged; pilot study; randomized controlled trial; very elderly; Acute Disease; Aged; Aged, 80 and over; Blood Glucose; Critical Care; Female; Humans; Hypoglycemia; Insulin Glargine; Male; Middle Aged; Pilot Projects; Stroke
Publisher
Nature Research
Type
journal article