Continuous glucose monitoring in acute stroke
"Hyperglycaemia upon admission is a pathophysiological response to acute brain ischemia that has been independently associated with high mortality rate and poor prognosis. Glycaemic variability (GV) has also shown association with poor clinical outcomes among stroke patients. GV is best assessed by continuous glucose monitoring (CGM), which enables consecutives glucose measurements every 5 minutes. This pilot study aimed: 1) To describe safety, feasibility and tolerability of CGM in the acute stroke setting; and 2) To compare CGM and conventional FS glucose-based monitoring regimen in terms of their relationship with GUA and the accuracy of hypoglycaemic episodes detection. Safety, feasibility and tolerability of CGM was excellent in our cohort of 23 patients with acute stroke (61% ischemic and 39% intracerebral haemorrhage) and there were no adverse events. CGM recorded ten hypoglycaemic episodes that were not detected by conventional FS monitoring. GUA was associated with coefficient of variation (CV) of CGM (p=0.03), CV of FS (p=0.01), standard deviation (SD) of CGM (p-value=0.01) and mean amplitude of glucose excursions (MAGE) (pvalue= 0.001)."