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Recent glycemic control can predict the progressive motor deficits of acute subcortical infarction with diabetes or prediabetes

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Abstract

Background and purpose

The predictors of progressive motor deficits in acute subcortical infarctions are still controversial. It is not known whether glycemic control influences on stroke progression.

Methods

A total of 268 consecutive patients with diabetes or prediabetes who had acute (< 24 h) subcortical infarction were enrolled. (1) All patients were divided into 4 groups by quartile of glycated hemoglobin (HbA1c). (2) Only the patients with diabetes were divided by effective glycemic control. Progressive motor deficits were prospectively captured and defined as an increase of motor score ≥ 1 on the upper or lower limb items of the National Institute of Health Stroke Scale within 72 h from stroke onset.

Results

Progressive motor deficits occur in 8/78 (10.3%) for ≤ 5.9, 15/61 (24.6%) for 6.0–6.4, 16/62 (25.8%) for 6.5–7.4, and 30/67 (44.8%) for ≥ 7.5. In diabetic patients alone, those occur in 5/37 (13.5%) for ≤ 6.5, 10/42 (23.8%) for 6.6–7.0, 12/42 (28.6%) for 7.1–8.0, and 24/50 (48.0%) for ≥ 8.1. An adjusted OR of progressive motor deficits was 2.61 (95% confidence interval [CI] 0.98–7.00, P = .056) for 6.0–6.4, 3.42 (95% CI 1.27–9.18, P = .015) for 6.5–7.4, and 6.65 (95% CI 2.38–18.62, P < .001) for ≥ 7.5. In diabetic patients alone, those were 3.15 (95% CI 0.89–11.15, P = .075) for 6.6–7.0, 2.90 (95% CI 0.79–10.61, P = .107) for 7.1–8.0, and 4.17 (95% CI 1.07–16.25, P = .038) for ≥ 8.1. The optimal cutoff value of HbA1c was 6.65% in discriminating progressive motor deficits.

Conclusion

Increased HbA1c was associated with higher incidence of progressive motor deficits in acute subcortical infarction with diabetes and prediabetes.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Funding

This study was supported by the (1) Yuhan Corporation and (2) Soonchunhyang University Research Fund.

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Authors and Affiliations

  1. Departments of Neurology, Soonchunhyang University School of Medicine, 59 Daesakwan-ro, Yong san-gu, Seoul, 04401, South Korea

    Kayeong Im, Hyunjin Ju, Mina Lee, Byung-Euk Joo, Kyum-Yil Kwon, Hakjae Roh, Moo-Young Ahn, Hye-Won Hwang & Kyung Bok Lee

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  1. Kayeong Im
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  2. Hyunjin Ju
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  3. Mina Lee
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  4. Byung-Euk Joo
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  7. Moo-Young Ahn
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Contributions

All authors contributed to the study conception and design: Material preparation by Kayeong Im and Kyung Bok Lee; data collection by Hyunjin Ju, Mina Lee, Byung-Euk Joo, Kyum-Yil Kwon, Hakjae Roh, and Moo-Young Ahn; analysis by Hye-Won Hwang. The first draft of the manuscript was written by Kayeong Im, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Kyung Bok Lee.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The study design was approved by the local institutional review board before study initiation (No. 2019-11-028-001).

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All patients agreed on the informed consent form for the stroke registry at admission.

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Im, K., Ju, H., Lee, M. et al. Recent glycemic control can predict the progressive motor deficits of acute subcortical infarction with diabetes or prediabetes. Neurol Sci 42, 285–291 (2021). https://doi.org/10.1007/s10072-020-04634-9

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