ROLE OF GLYCATED HEMOGLOBIN (HbA1c) ON SEVERITY OF ISCHEMIC STROKE IN PATIENTS WITH (TYPE1AND 2) DIABETES MELLITUS

Abstract

Diabetes mellitus is a metabolic disorder that can interact with atherosclerosis in ischemic strokes to initiate, activate and propagate vascular events. Glycated hemoglobin (HbA1c) has emerged as a useful biochemical marker reflecting the average glycemic control over the last 3 months, its prognostic value in the acute neurological conditions such as stroke is still not well-established. To study the effect of glycemic status (HbA1c) on severity of acute ischemic stroke in patients with diabetes (type1 and 2) at admission. This was a prospective cross sectional, hospital-based study done at Aden public and private hospitals for a period of thirteen months (January 2020 to February 2021). We evaluated 75 diabetic patients with acute ischemic stroke which was confirmed by brain computed tomography (CT scan). All subjects had blood hemoglobin A1c (HbA1c) measured at admission. They were classified into two groups according to the level of HbA1c: good glycemic control group ((GGC)) HbA1c<7.0% and poor glycemic control group((PGC))) HbA1c ≥7). Neurological impairment was evaluated by using the National Institutes of Health Stroke Scale (NIHSS). A higher percentage of patients (84%) with acute ischemic stroke had elevated HbA1C levels (≥7), High percentage of patients in PGC (66.7%) as well as who were in GGC (75%) had moderate to severe stroke (NIHSS >8). The association between stroke severity and HbA1C levels on admission was statistically not significant (P value> 0.05). We found that HbA1c cannot be used for predication of severity in diabetic patients with ischemic stroke. Our results provide evidence that although chronic hyperglycemia increases risk of stroke, it is not associated with increased stroke severity.