There is an increasing need for improved treatments for stroke patients as stroke is the most common cause of serious long term adult disability and the third most common cause of death in the United States. Hyperglycemia is seen in approximately 40% of acute ischemic stroke patients and has been associated with worse clinical outcomes.
Intravenous (IV) insulin therapy with tight glucose control has been found to improve clinical outcomes in some non-stroke acute illness trials. Current stroke guidelines emphasize the need for definitive clinical trials to determine best practice for managing hyperglycemia in acute stroke patients. A clear determination of the risk and benefit of glucose control with IV insulin would have a dramatic impact on acute ischemic stroke patient therapy.
Objective #1: To determine the efficacy of tight glucose control to a target range of 80-130 mg/dL with IV insulin infusion in hyperglycemic acute ischemic stroke patients within 12 hours of symptom onset as measured by mRS at 90 days after stroke.
Objective #2: To determine the safety of tight glucose control with IV insulin infusion in hyperglycemic acute ischemic stroke patients treated for up to 72 hrs.