Skip to main content

Strict Glucose Control After Acute Stroke Can Be Provided in the Prehospital Setting

Buy Article:

$51.00 plus tax (Refund Policy)


ACADEMIC EMERGENCY MEDICINE 2011; 18:436–439 © 2011 by the Society for Academic Emergency Medicine Abstract Objectives: 

The objective was to assess the feasibility of insulin infusion and subcutaneous insulin administered in the prehospital setting and their relative effect on hyperglycemia, a predictor of unfavorable outcome, in acute stroke patients. Methods: 

Hyperglycemic patients (plasma glucose >6.0 mmol/L) with stroke symptoms were randomized prior to or during transport to the hospital to receive either 1) a single subcutaneous dose of short-acting insulin (n = 11) or 2) a continuous intravenous (IV) insulin infusion (n = 12) at a rate adjusted by glucose levels measured every 10 minutes and targeted to plasma glucose 4.5–6.0 mmol/L. The changes in plasma glucose concentration were compared with a nonrandomized control group (n = 38) receiving standard care. Results: 

The baseline characteristics did not differ between the study groups. Plasma glucose concentration was significantly decreased during the prehospital phase in the IV-treated group in comparison to the control group (difference between groups –1.9 mmol/L, 95% confidence interval [CI] = –3.5 to –0.27) with no serious adverse events. In contrast, subcutaneous insulin did not achieve significant lowering of plasma glucose (–0.9 mmol/L, 95% CI = –2.4 to 0.6). Conclusions: 

This small sample suggests that adjusted insulin infusion efficiently lowers blood glucose in the ultra-acute phase of stroke and is feasible in the prehospital setting.

Document Type: Research Article


Publication date: 2011-04-01

  • Access Key
  • Free ContentFree content
  • Partial Free ContentPartial Free content
  • New ContentNew content
  • Open Access ContentOpen access content
  • Partial Open Access ContentPartial Open access content
  • Subscribed ContentSubscribed content
  • Partial Subscribed ContentPartial Subscribed content
  • Free Trial ContentFree trial content
Cookie Policy
Cookie Policy
Ingenta Connect website makes use of cookies so as to keep track of data that you have filled in. I am Happy with this Find out more