Glucose Regulation in Acute Stroke Patients (GRASP) Study
试验速览
- 阶段
- 2 期
- 状态
- 已完成
- 入组人数
- 74
- 试验地点
- 2
- 主要终点
- Hypoglycemic Events
研究概览
简要总结
The purpose of this study is to assess the feasibility, safety and preliminary efficacy of the use of insulin infusions as treatment for hyperglycemic acute ischemic stroke patients.
详细描述
Ischemic stroke is a common, devastating and costly disease. Half of acute stroke patients have elevated glucose levels upon admission to the hospital, and hyperglycemia is associated with poor outcome for post-stroke patients. It is unclear if treatment of hyperglycemia or glucose lowering improves outcome, however, in animal stroke models and other human conditions, aggressive glucose lowering is beneficial.
The goal of this multicenter trial is to determine if tight control of blood glucose is beneficial in hyperglycemic patients with acute ischemic stroke. In the trial, researchers will compare intravenous (IV) glucose insulin and potassium (GIK) therapy plus meal insulin to control therapy in 72 stroke patients.
Participants will be randomly assigned to one of three groups-(1) the control group with a target glucose level of <300mg/dL; (2) the tight control GIK plus meal insulin group with a target of <110mg/dL; or (3) the loose control GIK plus meal insulin group with a target of <200mg/dL-with all groups avoiding glucose levels of <70mg/dL.
The specific aims of this study are to collect preliminary data on the safety and feasibility of GIK for treatment of hyperglycemia in acute stroke patients, and to collect preliminary data comparing tight GIK therapy with loose GIK therapy and control therapy. Information learned in this study will compliment ongoing work and allow for maximum efficiency in the design of future treatment trials.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •18 years of age or older.
- •Clinical diagnosis of ischemic stroke defined as acute neurological deficit occurring in one or more major vessels.
- •Must arrive at hospital and be able to begin treatment within 2 hours of established eligibility and this must be within 24 hours of symptom onset. - - Patients unable to report symptom onset time or those awakening with symptoms must use the time last known to be well as the onset time.
- •Admission plasma glucose of > 110 mg/dL.
排除标准
- •Renal dysfunction as defined by a serum creatinine of >/=2.5 mg/dL at enrollment.
- •Substantial pre-existing neurological or psychiatric illness that would confound neurological assessment.
- •Patients who have received experimental therapy for the enrollment stroke.
- •Pregnant females.
- •Patients with other severe life threatening conditions that makes them unlikely to survive 90 days.
- •Patients who are unable to follow the protocol or come back for 90-day followup.
- •Patient has condition for which insulin infusion is the usual practice or the treating physician feels that there is an indication for insulin infusion.
研究组 & 干预措施
tight control group
target glucose level 70-110 mg/dL
干预措施: IV glucose insulin and potassium, GIK (Drug)
loose control group
target glucose level 70 - 200 mg/dL
干预措施: IV glucose insulin and potassium, GIK (Drug)
usual care group
target level 70 - 300 mg/dL
干预措施: standard care (Other)
结局指标
主要结局
Hypoglycemic Events
时间窗: up to 5 days
hypoglycemic events
次要结局
- Favorable 3 Month Modified Rankin(3 months)