Hyperglycemia and free radical imbalance as prognostic factors in acute stroke

We evaluated 395 patients with acute stroke: diabetes mellitus was diagnosed in 19.5%, hyperglycemia was observed in 41.8% patients on day 1 and in 48.9% on day 2 after admission. Hyperglycemia and diabetes were associated with more severe free radical imbalance and worsened the outcome in stroke patients, decreasing rehabilitation potential. The increase of malonic dialdehyde (MDA), decrease of antiperoxide plasma activity (APA), hyperglycemia and high leucocyte count are shown to be prognostic factors of adverse outcome (death, severe disability), which should be taken into account during antioxidant therapy. The highest mortality rate, which showed correlation with the size of stroke, was observed in patients with hyperglycemia persisting more than 3 days after stroke onset, and it was 1.8-fold higher than in patients with normoglycemia. Indications for target antioxidant therapy are: blood glucose > 6.6 mmol/l, leucocyte count >9 700, APC level 4 μmol/l