Glycemic variability: prognostic impact on acute ischemic stroke and the impact of corrective treatment for hyperglycemia. The GLIAS-III translational study
Por:
Fuentes, B, Pastor-Yborra, S, Gutierrez-Zuniga, R, de Villar, NGP, de Celis, E, Rodriguez-Pardo, J, Gomez-de Frutos, MC, Laso-Garcia, F, Gutierrez-Fernandez, M, Ortega-Casarrubios, M, Soto, A, Lopez-Fernandez, M, Santamaria, M, Diez-Gonzalez, N, Freijo, MM, Zandio, B, Delgado-Mederos, R, Calleja, A, Portilla-Cuenca, JC, Lisbona, A, Otero-Ortega, L, Diez-Tejedor, E
Publicada:
4 nov 2020
Resumen:
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 sensor 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.
Discussion: The GLIAS-III study will be the first translational approach analyzing the prognostic influence of GV, evaluated by the use of subcutaneous glucose monitors, in acute stroke.
Filiaciones:
Fuentes, B:
Univ Autonoma Madrid, La Paz Univ Hosp, Hosp La Paz, Inst Hlth Res IdiPAZ,Dept Neurol, Paseo Castellana 261, Madrid 28046, Spain
Univ Autonoma Madrid, La Paz Univ Hosp, Hosp La Paz, Inst Hlth Res IdiPAZ,Stroke Ctr, Paseo Castellana 261, Madrid 28046, Spain
Pastor-Yborra, S:
Univ Autonoma Madrid, La Paz Univ Hosp, Hosp La Paz, Inst Hlth Res IdiPAZ,Dept Neurol, Paseo Castellana 261, Madrid 28046, Spain
Univ Autonoma Madrid, La Paz Univ Hosp, Hosp La Paz, Inst Hlth Res IdiPAZ,Stroke Ctr, Paseo Castellana 261, Madrid 28046, Spain
Gutierrez-Zuniga, R:
Univ Autonoma Madrid, La Paz Univ Hosp, Hosp La Paz, Inst Hlth Res IdiPAZ,Dept Neurol, Paseo Castellana 261, Madrid 28046, Spain
Univ Autonoma Madrid, La Paz Univ Hosp, Hosp La Paz, Inst Hlth Res IdiPAZ,Stroke Ctr, Paseo Castellana 261, Madrid 28046, Spain
de Villar, NGP:
Univ Autonoma Madrid, La Paz Univ Hosp, Hosp La Paz, Inst Hlth Res IdiPAZ,Dept Endocrinol, Paseo Castellana 261, Madrid 28046, Spain
de Celis, E:
Univ Autonoma Madrid, La Paz Univ Hosp, Hosp La Paz, Inst Hlth Res IdiPAZ,Dept Neurol, Paseo Castellana 261, Madrid 28046, Spain
Univ Autonoma Madrid, La Paz Univ Hosp, Hosp La Paz, Inst Hlth Res IdiPAZ,Stroke Ctr, Paseo Castellana 261, Madrid 28046, Spain
Rodriguez-Pardo, J:
Univ Autonoma Madrid, La Paz Univ Hosp, Hosp La Paz, Inst Hlth Res IdiPAZ,Dept Neurol, Paseo Castellana 261, Madrid 28046, Spain
Univ Autonoma Madrid, La Paz Univ Hosp, Hosp La Paz, Inst Hlth Res IdiPAZ,Stroke Ctr, Paseo Castellana 261, Madrid 28046, Spain
Gomez-de Frutos, MC:
Univ Autonoma Madrid, La Paz Univ Hosp, Hosp La Paz,Dept Neurol, Inst Hlth Res IdiPAZ,Neurol Sci & Cerebrovasc Res, Paseo Castellana 261, Madrid 28046, Spain
Univ Autonoma Madrid, La Paz Univ Hosp, Hosp La Paz, Inst Hlth Res IdiPAZ,Stroke Ctr,Neurosci Area, Paseo Castellana 261, Madrid 28046, Spain
Laso-Garcia, F:
Univ Autonoma Madrid, La Paz Univ Hosp, Hosp La Paz,Dept Neurol, Inst Hlth Res IdiPAZ,Neurol Sci & Cerebrovasc Res, Paseo Castellana 261, Madrid 28046, Spain
Univ Autonoma Madrid, La Paz Univ Hosp, Hosp La Paz, Inst Hlth Res IdiPAZ,Stroke Ctr,Neurosci Area, Paseo Castellana 261, Madrid 28046, Spain
Gutierrez-Fernandez, M:
Univ Autonoma Madrid, La Paz Univ Hosp, Hosp La Paz,Dept Neurol, Inst Hlth Res IdiPAZ,Neurol Sci & Cerebrovasc Res, Paseo Castellana 261, Madrid 28046, Spain
Univ Autonoma Madrid, La Paz Univ Hosp, Hosp La Paz, Inst Hlth Res IdiPAZ,Stroke Ctr,Neurosci Area, Paseo Castellana 261, Madrid 28046, Spain
Ortega-Casarrubios, M:
Univ Complutense Madrid, Hosp Univ 12 Octubre, Dept Neurol, Madrid, Spain
Soto, A:
Hosp Univ A Coruna, Dept Endocrinol, La Coruna, Spain
Lopez-Fernandez, M:
Hosp Univ A Coruna, Dept Endocrinol, La Coruna, Spain
Santamaria, M:
Univ Autonoma Madrid, La Paz Univ Hosp, Hosp La Paz, Inst Hlth Res IdiPAZ,Dept Neurol, Santiago De Compostela, Spain
Diez-Gonzalez, N:
Hosp Donostia, Dept Neurol, San Sebastian, Spain
Freijo, MM:
Hosp Univ Cruces, Biocruces Bizkaia Hlth Res Inst, Dept Neurol, Bizkaia, Spain
Zandio, B:
Complejo Hosp Navarra, Dept Neurol, Pamplona, Spain
Delgado-Mederos, R:
Hosp Santa Creu & Sant Pau, Dept Neurol, Barcelona, Spain
Calleja, A:
Hosp Clin Univ Valladolid, Dept Neurol, Valladolid, Spain
Portilla-Cuenca, JC:
Hosp San Pedro de Alcantara, Dept Neurol, Caceres, Spain
Lisbona, A:
Univ Autonoma Madrid, La Paz Univ Hosp, Hosp La Paz, Inst Hlth Res IdiPAZ,Dept Endocrinol, Paseo Castellana 261, Madrid 28046, Spain
Otero-Ortega, L:
Univ Autonoma Madrid, La Paz Univ Hosp, Hosp La Paz,Dept Neurol, Inst Hlth Res IdiPAZ,Neurol Sci & Cerebrovasc Res, Paseo Castellana 261, Madrid 28046, Spain
Univ Autonoma Madrid, La Paz Univ Hosp, Hosp La Paz, Inst Hlth Res IdiPAZ,Stroke Ctr,Neurosci Area, Paseo Castellana 261, Madrid 28046, Spain
Diez-Tejedor, E:
Univ Autonoma Madrid, La Paz Univ Hosp, Hosp La Paz, Inst Hlth Res IdiPAZ,Dept Neurol, Paseo Castellana 261, Madrid 28046, Spain
Univ Autonoma Madrid, La Paz Univ Hosp, Hosp La Paz, Inst Hlth Res IdiPAZ,Stroke Ctr, Paseo Castellana 261, Madrid 28046, Spain
Green Published, gold
|