Glucose in acute ischemic stroke: Effects and options for monitoring and treatment

Ischemic stroke is a major cause of disability in developed countries. The only treatment to improve outcome consists of rapid recanalization by means of intravenous thrombolysis (IVT) or endovascular therapy (EVT). Hyperglycemia on admission is commonly observed in acute ischemic stroke patients and has been associated with unfavorable outcomes. Several studies have investigated the effects of actively lowering glucose in patients with acute ischemic stroke and hyperglycemia. These studies, however, have not shown any significant effect on infarct size or functional outcome. This lack of efficacy is probably related to insufficiently accurate glucose monitoring and insufficiently precise glucose-lowering.
The aims of this thesis were to study the relation between hyperglycemia in the acute phase and outcomes of patients with acute ischemic stroke treated with EVT, to develop a more accurate approach for glucose monitoring during acute ischemic stroke, and to explore alternatives to insulin as a glucose-lowering therapy in these patients.