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About 40% of patients with acute ischemic stroke have hyperglycemia. Previous studies have linked hyperglycemia with worse outcomes, including increased infarct growth and higher rates of hemorrhagic transformation. Whether aggressive treatment of hyperglycemia improves outcomes following ischemic stroke is unclear; the SHINE study group conducted a multicenter U.S. trial to investigate.
Over a 6-year period, 1151 subjects with acute stroke of less than 12 hours' duration and hyperglycemia (defined as glucose levels of >110 mg/dL for patients with diabetes and >150 mg/dL for patients without diabetes) were recruited. Mean age was 66 years; 46% were women; median NIH stroke scale score was 7; 63% of subjects received alteplase treatment. Pati…