Glycemic variability: prognostic impact on acute ischemic stroke and the impact of corrective treatment for hyperglycemi
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Journal of Translational Medicine Open Access
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Glycemic variability: prognostic impact on acute ischemic stroke and the impact of corrective treatment for hyperglycemia. The GLIAS‑III translational study Blanca Fuentes1*† , Silvia Pastor‑Yborra1, Raquel Gutiérrez‑Zúñiga1, Noemí González‑Pérez de Villar2, Elena de Celis1, Jorge Rodríguez‑Pardo1, Mari Carmen Gómez‑de Frutos3, Fernando Laso‑García3, María Gutiérrez‑Fernández3, MÁngeles Ortega‑Casarrubios4, Alfonso Soto5, María López‑Fernández5, María Santamaría6, Noemí Díez‑González7, Mar M. Freijo8, Beatriz Zandio9, Raquel Delgado‑Mederos10, Ana Calleja11, Juan Carlos Portilla‑Cuenca12, Arturo Lisbona2, Laura Otero‑Ortega3*† and Exuperio Díez‑Tejedor1
Abstract Introduction: Glycemic variability (GV) represents the amplitude of oscillations in glucose levels over time and is associated with higher mortality in critically ill patients. Our aim is to evaluate the impact of GV on acute ischemic stroke (IS) outcomes in humans and explore the impact of two different insulin administration routes on GV in an animal model. Methods: This translational study consists of two studies conducted in parallel: The first study is an observational, multicenter, prospective clinical study in which 340 patients with acute IS will be subcutaneously implanted a sen‑ sor to continuously monitor blood glucose levels for 96 h. The second study is a basic experimental study using an animal model (rats) with permanent occlusion of the middle cerebral artery and induced hyperglycemia (through an intraperitoneal injection of nicotinamide and streptozotocin). The animal study will include the following 6 groups (10 animals per group): sham; hyperglycemia without IS; IS without hyperglycemia; IS and hyperglycemia without treatment; IS and hyperglycemia and intravenous insulin; and IS and hyperglycemia and subcutaneous insulin. The endpoint for the first study is mortality at 3 months, while the endpoints for the animal model study are GV, functional recovery and biomarkers.
*Correspondence: [email protected]; laura.otero@salud. madrid.org † Blanca Fuentes and Laura Otero-Ortega contributed equally to this study. 1 Department of Neurology and Stroke Centre, Hospital La Paz Institute for Health Research-IdiPAZ (La Paz University Hospital, Universidad Autónoma de Madrid), Paseo de la Castellana 261, 28046 Madrid, Spain 3 Neurological Sciences and Cerebrovascular Research Laboratory, Department of Neurology and Stroke Centre, Neuroscience Area, Hospital La Paz Institute for Health Research-IdiPAZ (La Paz University Hospital, Universidad Autónoma de Madrid), Paseo de la Castellana 261, 28046 Madrid, Spain Full list of author information is available at the end of the article © The Author(s) 2020. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to
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