Intravenous Insulin Did Not Improve Stroke Outcomes

A study presented at the AHA/ASA International Stroke Conference 2019 explained that intravenous (IV) insulin did not improve stroke outcomes in comparison to the standard blood sugar control using shots.

“Hyperglycemia, or increased glucose, is common in patients with acute ischemic stroke and is associated with poor recovery. There is a worldwide debate about the best way to control glucose levels in these patients,” explained the report. 

The Stroke Hyperglycemia Insulin Network Effort (SHINE) study analyzed the efficacy and safety of using continuous IV insulin infusion vs standard subcutaneous insulin injections in a multicenter, randomized, controlled trial of 1151 patients in 63 different US sites. 

Researchers presented that “intense glucose therapy via IV insulin, which lowers glucose to a target of 80-130 milligrams per deciliter (mg/dL), does not improve functional outcomes at 90 days compared to standard glucose control using insulin shots, which aims to lower glucose below 180 mg/dL.”

The study also revealed, intense glucose therapy increases the risk of very low blood glucose (hypoglycemia) and requires more resources such as increased supervision from nursing staff.”

“This study provides clear evidence to guide the control of glucose levels in patients experiencing acute ischemic stroke and hyperglycemia, or increased glucose,” said Karen C. Johnston, MD, MSc, professor of neurology and associate vice president for Clinical & Translational Research at the University of Virginia in Charlottesville.—Edan Stanley