Toggle Main Menu Toggle Search

Open Access padlockePrints

Glucose potassium insulin infusions in the treatment of acute stroke patients with mild to moderate hyperglycemia: The glucose insulin in stroke trial (GIST)

Lookup NU author(s): Joyce French, Dr Janice O'Connell, Professor Christopher Gray


Full text for this publication is not currently held within this repository. Alternative links are provided below where available.


Background and Purpose-Hyperglycemia following acute stroke is strongly associated with subsequent mortality and impaired neurological recovery, but it is unknown whether maintenance of euglycemia in the acute phase improves prognosis. Furthermore, the safety of such intervention is not established. Methods-In an explanatory, randomized, controlled trial to test safety, 53 acute (within 24 hours of ictus) stroke patients with mild to moderate hyperglycemia (plasma glucose between 7.0 and 17.0 mmol/L) were randomized to receive either a 24-hour infusion of 0.9% (154 mmol/L) saline or a glucose potassium insulin (GKI) infusion at 100 mL/h. The GKI consisted of 16 U human soluble insulin and 20 mmol potassium chloride in 500 mL 10% glucose. Blood glucose was measured every 2 hours with Boehringer Mannheim Glycaemie test strips, pulse and blood pressure were measured every 4 hours, and plasma glucose samples were taken every 8 hours. Insulin concentration in the GKI was altered according to BM glucose values. Results-There were no statistically significant differences between the 2 groups at baseline. Twenty-five patients received GKI, 1 of whom required intravenous glucose for symptomatic hypoglycemia. Plasma glucose levels were nonsignificantly lower in the GKI group throughout the infusion period. Four-week mortality in the GKI group was 7 (28%), compared with 8 (32%) in the control group. Conclusions-GKI infusions can be safely administered to acute stroke patients with mild to moderate hyperglycemia producing a physiological but attenuated glucose response to acute stroke, the effectiveness of which remains to be elucidated.

Publication metadata

Author(s): Scott JF, Robinson GM, French JM, O'Connell JE, Alberti KGMM, Gray CS

Publication type: Article

Publication status: Published

Journal: Stroke

Year: 1999

Volume: 30

Issue: 4

Pages: 793-799

Print publication date: 01/04/1999

ISSN (print): 0039-2499

ISSN (electronic): 1524-4628

Publisher: Lippincott Williams & Wilkins


DOI: 10.1161/01.STR.30.4.793

PubMed id: 10187881


Altmetrics provided by Altmetric