Hyperglycemia during ischemic stroke is associated with worse outcomes, such as endothelial dysfunction, increased oxidative stress, impaired fibrinolysis, and increased inflammatory response. The objective of this randomized clinical trial was to determine the efficacy of intensive treatment of hyperglycemia during acute ischemic stroke. Participants in the intensive treatment group received continuous IV insulin and participants in the standard treatment group received insulin on a sliding scale subcutaneously. Participants were chosen if they had hyperglycemia and acute ischemic stroke with NIHSS of 3-22, presenting within 12 hours from stroke onset, and were 18 years of age or older. The primary efficacy outcome was the proportion of patients with a favorable outcome at 90 days after randomization. Key secondary outcomes included 90-day NIHSS score (measuring residual neurological deficits), 90-day Barthel Index score (measuring residual limitations in activities of daily living), and 90-day Stroke Specific Quality of Life score. This RCT concluded that treatment with intensive glucose control compared with standard glucose control for up to 72 hours did not result in a significant difference in favorable functional outcome at 90 days. Additionally, severe hypoglycemia occurred among patients in the intensive treatment group.
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