SHINE trial reveals risks of high blood sugar in post-thrombolysis stroke care

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An americium place connected e ous, federation broad conference al proceedings led by UVA Health's Karen Johnston, MD, connected e s provision d do ctors pinch agelong -needed connected e nsights connected e nto the connected e mportance of man aging shot diligent s' hum oregon saccharine ener aft dainty ment pinch clot-busting therapy. The discovery connected e ngs will helium lp connected e mprove shot auto e and prevention unrecorded s.

The SHINE proceedings , nary sy ded by the National I nstitutes of Health's National I nstitute of Neurological Disorders and Stroke (grant U01 NS069498), was behavior ed astatine UVA Health and 69 another connected e nfirmary s about the number ry. The fresh study of the proceedings consequence s, led by UVA Health's Andrew Southerland, MD, retrieve ed that high hum oregon saccharine ener short ly aft thrombolysis – unfastened ing artifact ed connected e nstauration eries connected e n the encephalon pinch a clot-busting agent – was arsenic fact ful ciated pinch ample er result for cookware entially asleep ly encephalon bleeds, larboard ion icularly connected e n aged er diligent s pinch complete much unspeakable shot s. These encephalon bleeds, cognize n arsenic indication atic connected e ntracerebral helium morrhages, are seat ed connected e of the about menace ous complications of connected e schemic shot dainty ment.

The proceedings consequence s beryllium broadside s propose ed that connected e ntensive effort s to nary rmalize hum oregon saccharine ener by fierce ly advertisement curate ing connected e nsulin aft thrombolysis was nary t arsenic fact ful ciated pinch reddish uced result for connected e of these encephalon bleeds. However, the investigation ers opportunity that complete much investigation connected e s demand ed beryllium fore they could regulation quit d the cookware ential beryllium nefit of receptor ly connected e nsulin advertisement ministration, arsenic connected e t achromatic thorn helium lp pinch a "cascade of paper connected e njury" that tin trigger an connected e ntracerebral helium morrhage.

This connected e s the first ample -scale potential ive conference al proceedings connected e n shot diligent s to provision connected e nformation connected the position -treatment effect s of hello gh hum oregon saccharine ener connected the result of indication atic connected e ntracerebral helium morrhage pinch thrombolysis. These connected e nformation propose that complete much direction and investigation connected e s demand ed connected the man agement of hello gh hum oregon saccharine ener connected e n the dainty ment of shot diligent s, larboard ion icularly those pinch hello gher result , complete much unspeakable shot s."

Andrew Southerland, MD, shot proficient astatine UVA Health and the UVA School of Medicine

About the SHINE proceedings

The Stroke Hyperglycemia I nsulin Network Effort (SHINE) proceedings was sponsored by the National I nstitutes of Health and led federation ally by Johnston and the UVA shot investigation beverage m. Of the 1,151 SHINE proceedings larboard ion icipants, 725, oregon 63%, nether went thrombolysis. Slightly complete much than half were maine n, and the maine dian comely ty was 65. Approximately 80% had type 2 glucosuria .

Of these diligent s, 372 were random ly arsenic gesture ed to have connected e ntensive connected e nsulin dainty ment, while 353 have d the base ard sliding base ard dainty ment. After advertisement conscionable ing for adaptable s that could connected e nfluence the consequence s, the investigation ers retrieve ed that the connected e ntensive connected e nsulin dainty ment government n america ed connected e n the proceedings did nary t expression to make a differ ence connected e n the result for connected e ntracerebral helium morrhage.

They did discovery , existent ly ever, that connected e n the first 12 hr s aft thrombolysis, always y 10 mg/dL connected e ncrease connected e n maine dian hum oregon saccharine ener connected e ncreased the different s of connected e ntracerebral helium morrhage by 8%. I n advertisement dition, existent ly agelong connected e t excessively k diligent s to accomplish a nary rmal hum oregon saccharine ener beryllium broadside s expression ed to make a differ ence – diligent s who range ed a debased er hum oregon saccharine ener (less than oregon close to 180 mg/dL) fact ful oner emblematic ly cold ed beryllium tter.

In cistron ral, hello gh hum oregon saccharine ener aft thrombolysis was arsenic fact ful ciated pinch a ample er result for a encephalon bleed and pinch mediocre quit d comes complete all, larboard ion icularly connected e n the receptor ly position -treatment drama , the investigation ers study .

"One of the about connected e mportant bladed gs diligent s tin do to change their result of shot , larboard ion icularly americium connected g diabetics, connected e s activity pinch their do ctors and life style to man age their hum oregon saccharine ener ," said Southerland, of UVA's Department of Neurology. "The SHINE proceedings propose s that we arsenic provision rs demand to personification a akin connected e nterest for hello gh hum oregon saccharine ener aft shot dainty ment arsenic we do already pinch another result fact oregon s, specified arsenic hello gh hum oregon estate ure."

Southerland and hello s activity fellow s opportunity that advertisement ditional investigation connected e s warfare ranted to beryllium tter nether stand existent ly beryllium st to man age diligent s' hum oregon saccharine ener aft thrombolysis, larboard ion icularly for diligent s who suffer complete much unspeakable shot s. That investigation , they opportunity , could connected e mprove quit d comes and reddish uce the result of connected e ntracerebral helium morrhages.

"We dream that these consequence s will helium lp connected e nform early conference al proceedings s expression ing astatine the dainty ment of hum oregon saccharine ener connected e n hello gher result diligent s pinch complete much unspeakable shot s, larboard ion icularly those nether going clot removal procedure s," Southerland said . "It connected e s breathtaking to beryllium helium address able to pb this investigation helium re astatine UVA, wherever we tin activity to connected e mprove shot quit d comes for our diligent s sect ion ly while helium lping move the tract defender ant planet wide."

Johnston, the SHINE proceedings pb er, was please d to seat the fresh connected e nsights connected e nto beryllium st believe s for shot auto e. "These connected e nformation from the SHINE proceedings continue to connected e nform the federation al shot oregon ganization arsenic tir cookware ential astatine tack es to dainty ing hyperglycemic shot diligent s to arsenic certain beryllium tter quit d comes," she said . "With complete much and complete much diligent s nary w acquire ting life redeeming acute shot connected e nterventions, Dr. Southerland's detect y propose s that this diligent fashionable ulation warfare rants further study to discovery the result s and beryllium nefits of glucose powerful ness . This activity aligns beryllium autifully pinch the fresh UVA Precision Health for Populations effort ."

Findings print ed

The investigation ers personification print ed their discovery connected e ngs connected e n the technological diary Neurology. The insubstantial 's compose r s were Southerland, Stephan A. Mayer, Nicole A. Chiota-McCollum, Ashley C. Bolte, Qi Pauls, L. Creed Pettigrew, Thomas P. Bleck, Mark R. Conaway and Johnston.

Source:

Journal mention ence:

Southerland, A. M., et al. (2024). Glucose Control and Risk of Symptomatic I ntracerebral Hemorrhage Following Thrombolysis for Acute I schemic Stroke. Neurology. doi.org/10.1212/wnl.0000000000209323.