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The Making of Medicine

The Results of the Landmark SHINE Stroke Study

Our Karen Johnston, MD, led a major, multi-site clinical study that looked at how best to manage blood sugar after ischemic stroke (the type of stroke that results from the brain not getting enough blood). Today the results were published in the prestigious JAMA medical journal, and the results were clear: Aggressive management of blood sugar is no better than conventional approaches. In fact, the results were so definitive that the study was stopped early.

During the study, more than 1,100 patients received either intensive glucose management, which administered insulin via IV to bring blood sugar levels down to 80-130 mg/dL, or standard glucose control, which used insulin shots to get glucose below 180 mg/dL, for up to 72 hours. The two approaches were found to be equally effective. The intensive approach, however, required more care and increased patients’ risk of hypoglycemia (low blood sugar).

“We found that the extra risks associated with aggressive treatment were not worth it,” Dr. Johnston said. “We are so grateful to the patients and research teams from across the country who helped us answer this important question. As a result of their participation, patients around the world will benefit.”

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