Impact of diabetes and hyperglycemia on acute stroke outcomes in a semi urban setting in Cameroon: Results of the Buea Stroke Study, Cameroon

Abstract

BACKGROUND: Data on the impact of diabetes mellitus and hyperglycemia on acute stroke outcomes are inconsistent. This study aimed to assess the prognostic impact of diabetes mellitus and admission hyperglycemia on in-hospital stroke outcomes in a semi-urban setting in Cameroon. METHODS: We included patients aged ≥18 years hospitalized for acute stroke at the Buea Regional Hospital, Southwest Region of Cameroon, from January 2021 to August 2023. Multivariable logistic regression analysis was used to assess the impact of known diabetes mellitus and admission hyperglycemia on in-hospital functional outcome, infections, length of hospital stay, and mortality. Risk estimates are presented as adjusted odds ratios (aOR) with 95% confidence intervals (95% CI). A p value of <0.05 was considered significant. RESULTS: Out of the 369 patients recruited, 99 (26.8%) had diabetes. Of the 267 patients with blood glucose on admission, 81 (30.3%) had hyperglycemia. Patients with diabetes mellitus were significantly older (65.1 vs 61.1 years; p=0.03), had a higher prevalence of hypertension (84.9% vs 66.7%; p=0.001) and more commonly had ischemic stroke (85.9% vs 68.2%; p=0.001). In multivariable logistic regression analysis, diabetes mellitus was significantly associated with prolonged hospital stay (aOR= 2.20; 95% CI1.19-4.06; p=0.01) and infections (aOR= 2.36, 95% CI1.14-4.87; p=0.02) but not with in-hospital mortality and functional outcome. Admission hyperglycemia was not associated with any of the outcomes. CONCLUSION: In this cohort of patients in a resource limited setting, diabetes mellitus was associated with longer hospital stay and more frequent infections but not mortality nor poor functional outcome after an acute stroke. Admission hyperglycemia was not associated with poor outcomes.