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The Role of HbA1c Determination in Detecting Unknown Glucose Disturbances in Ischemic Stroke

OBJECTIVES: To evaluate the usefulness of hemoglobin A1c (HbA1c) determinations during the acute ischemic stroke (IS) to identify undiagnosed glucose disturbances in a prospective series of patients with first-ever IS. METHODS: Retrospective analysis of a prospective series of first-ever IS patients...

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Autores principales: Roquer, Jaume, Rodríguez-Campello, Ana, Cuadrado-Godia, Elisa, Giralt-Steinhauer, Eva, Jiménez-Conde, Jordi, Soriano, Carol, Ois, Angel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4259295/
https://www.ncbi.nlm.nih.gov/pubmed/25485761
http://dx.doi.org/10.1371/journal.pone.0109960
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author Roquer, Jaume
Rodríguez-Campello, Ana
Cuadrado-Godia, Elisa
Giralt-Steinhauer, Eva
Jiménez-Conde, Jordi
Soriano, Carol
Ois, Angel
author_facet Roquer, Jaume
Rodríguez-Campello, Ana
Cuadrado-Godia, Elisa
Giralt-Steinhauer, Eva
Jiménez-Conde, Jordi
Soriano, Carol
Ois, Angel
author_sort Roquer, Jaume
collection PubMed
description OBJECTIVES: To evaluate the usefulness of hemoglobin A1c (HbA1c) determinations during the acute ischemic stroke (IS) to identify undiagnosed glucose disturbances in a prospective series of patients with first-ever IS. METHODS: Retrospective analysis of a prospective series of first-ever IS patients. Patients with previous diagnosis of diabetes mellitus (DM) were excluded from the study. Patients were classified as non-DM (HbA1c<5.7% and no previous evidence of 2 or more fasting blood glucose> = 126 mg/dL), prediabetes (HbA1c from 5.7% to 6.4%), and new suspected DM (HbA1c> = 6.5% independently of current blood glucose). Medical charts from hospital discharge to July 2014 of all suspected DM patients were reviewed to confirm the DM diagnosis. RESULTS: The initial cohort included 1283 patients, of which 393 were excluded because of previous DM diagnosis and 136 because HbA1c during acute stroke phase was not available. No demographic differences were observed between patients with and without HbA1c determinations. The final cohort was composed of 754 patients with first-ever IS and unknown DM history. HbA1c determination suggested new DM in 87 cases (11.5%) and detected 273 patients with prediabetes (36.2%). New DM cases were identified in all etiological stroke subtypes. After discharge, DM diagnosis was confirmed in 80.2% of patients with available follow-up. CONCLUSIONS: HbA1c determination detected both undiagnosed DM and prediabetes in IS patients without taking into account the blood glucose values during admission, and independently of etiological stroke subtype. HbA1c determination should be included in the systematic screening of all IS patients.
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spelling pubmed-42592952014-12-15 The Role of HbA1c Determination in Detecting Unknown Glucose Disturbances in Ischemic Stroke Roquer, Jaume Rodríguez-Campello, Ana Cuadrado-Godia, Elisa Giralt-Steinhauer, Eva Jiménez-Conde, Jordi Soriano, Carol Ois, Angel PLoS One Research Article OBJECTIVES: To evaluate the usefulness of hemoglobin A1c (HbA1c) determinations during the acute ischemic stroke (IS) to identify undiagnosed glucose disturbances in a prospective series of patients with first-ever IS. METHODS: Retrospective analysis of a prospective series of first-ever IS patients. Patients with previous diagnosis of diabetes mellitus (DM) were excluded from the study. Patients were classified as non-DM (HbA1c<5.7% and no previous evidence of 2 or more fasting blood glucose> = 126 mg/dL), prediabetes (HbA1c from 5.7% to 6.4%), and new suspected DM (HbA1c> = 6.5% independently of current blood glucose). Medical charts from hospital discharge to July 2014 of all suspected DM patients were reviewed to confirm the DM diagnosis. RESULTS: The initial cohort included 1283 patients, of which 393 were excluded because of previous DM diagnosis and 136 because HbA1c during acute stroke phase was not available. No demographic differences were observed between patients with and without HbA1c determinations. The final cohort was composed of 754 patients with first-ever IS and unknown DM history. HbA1c determination suggested new DM in 87 cases (11.5%) and detected 273 patients with prediabetes (36.2%). New DM cases were identified in all etiological stroke subtypes. After discharge, DM diagnosis was confirmed in 80.2% of patients with available follow-up. CONCLUSIONS: HbA1c determination detected both undiagnosed DM and prediabetes in IS patients without taking into account the blood glucose values during admission, and independently of etiological stroke subtype. HbA1c determination should be included in the systematic screening of all IS patients. Public Library of Science 2014-12-08 /pmc/articles/PMC4259295/ /pubmed/25485761 http://dx.doi.org/10.1371/journal.pone.0109960 Text en © 2014 Roquer et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Roquer, Jaume
Rodríguez-Campello, Ana
Cuadrado-Godia, Elisa
Giralt-Steinhauer, Eva
Jiménez-Conde, Jordi
Soriano, Carol
Ois, Angel
The Role of HbA1c Determination in Detecting Unknown Glucose Disturbances in Ischemic Stroke
title The Role of HbA1c Determination in Detecting Unknown Glucose Disturbances in Ischemic Stroke
title_full The Role of HbA1c Determination in Detecting Unknown Glucose Disturbances in Ischemic Stroke
title_fullStr The Role of HbA1c Determination in Detecting Unknown Glucose Disturbances in Ischemic Stroke
title_full_unstemmed The Role of HbA1c Determination in Detecting Unknown Glucose Disturbances in Ischemic Stroke
title_short The Role of HbA1c Determination in Detecting Unknown Glucose Disturbances in Ischemic Stroke
title_sort role of hba1c determination in detecting unknown glucose disturbances in ischemic stroke
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4259295/
https://www.ncbi.nlm.nih.gov/pubmed/25485761
http://dx.doi.org/10.1371/journal.pone.0109960
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