Abstract 144: Study the correlation of glycosylated haemoglobin (Hba1c) with severity of ischemic stroke in patients with diabetes mellitus vs non-diabetics

Background: In current scenario, burden of diabetes is increasing in India with time and along with its complications that are microvascular and macrovascular, one of which is stroke. There is an increased risk of stroke and its severity when a patient has diabetes with poor glycemic control. There are very few studies which compare the severity of stroke in patients of diabetes with good and poor glycemic control with non diabetic. Therefore, this study was conducted to assess the impact of diabetes on the pattern and severity of stroke (ischemic) with the help of glycosylated haemoglobin (HbA1C), which is easily accessible and affordable, so that various medical therapies should be implemented to prevent it. Objectives: To know the glycemic status by estimating the HbA1c at the time of admission among all patients with acute ischemic stroke. To study the correlation of HbA1C on the severity of stroke at admission in diabetic patients. To compare the poor and good glycemic status patients among the diabetics with non-diabetic patients in acute ischemic stroke. Material and Method: This is a Case control observational study in which the total sample size was 200, out of which 100 patients were cases (diabetic) and controls (non diabetic) respectively. Results: In this study, cases were sub-categorized into good glycemic control- GGC (HbA1C < 7%) and poor glycemic control- PGC (HbA1C > 7%). Diabetes was more prevalent in male (58.5%) compared to female (41.5%) in which poor glycemic control was more common in males (55.8%) compared to females (44.2%). According to the TOAST Classification and NIHSS scoring systems, GGC has 16.7% of large artery occlusion and PGC has 36.5 percent of large artery occlusion. In the non diabetic group, 1% has large artery occlusion. In NIHSS score, 2% of patients have major stroke in the GGC group, 11.5% have severe stroke in the PGC group, and in the non diabetic group, 0.5% has severe stroke. Conclusion: Sunanda et al. (2016) discovered that glycemic control has a significant association with the severity and outcome of diabetic ischemic stroke patients using HbA1c estimation. The severity of ischemic stroke patients during hospital stay was examined in this study with non-diabetics as a control, resulting in a study with a stronger association. Among the diabetic stroke patients, the severity of deranged glycemic status was found to have an influence on the stroke severity. Estimation of HbA1c levels at the time of admission might be a predictor of the severity of neurological impairment and functional outcome in patients with acute ischemic stroke.