Intensive versus standard glucose control in patients with ischemic stroke: A meta-analysis of randomized controlled trials

Background Hyperglycemia is common in patients with ischemic stroke (IS) and has been proved to be associated with worse clinical outcomes. However, it is controversial whether intensive glucose control (IGC) is superior to standard glucose control (SGC). Therefore, we carry out this meta-analysis based on randomized controlled trial (RCT). Methods We systematically searched the RCT in the database that evaluated the efficacy of IGC versus SGC in IS patients. The retrieval time was limited from the establishment of the database to October 2019. The retrieval databases included PubMed, MEDLINE, EMBASE, OVID, web of science, Google Scholar and Chinese literature database. Two researchers independently screened and evaluated the quality of literature. We use Stata 13.0 software for data analysis. Odds ratio (OR) and 95% confidence interval (CI) were used to compare the results. Results Finally, seven RCT articles including 1691 participant were included in this study. Among these patients, 857 patients in the IGC group, and 834 patients in the SGC group. Our results show that IGC significantly increases the risk of hypoglycemia compared to SGC (OR=4.76, 95% CI 1.17 to 19.45). No significant difference was observed in modified rankin scale score≤2 (OR=0.97, 95% CI 0.75 to 1.25), national institutes of health stroke scale (NIHSS) score≤2 (OR=1.48, 95% CI 0.54 to 4.06) and death (OR=0.74, 95% CI 0.53 to 1.02) between the two groups within 3 months. Conclusions Our results suggest that there is no evidence that IGC is superior to SGC in IS patients, but increases the risk of hypoglycemia.