Abstract
<jats:p>Background. Acute ischemic stroke is one of the leading causes of mortality and persistent disability, especially in patients with type 2 diabetes mellitus and hyperglycemia in the acute phase. Elevated blood glucose levels, regardless of their origin, are associated with more severe neurological deficits, larger infarct volumes, and poorer functional outcomes. Standardized quantitative assessment of clinical status plays a crucial role in contemporary research. The National Institutes of Health Stroke Scale (NIHSS) enables objective evaluation of neurological deficit severity in the acute phase, whereas the modified Rankin scale (mRS) and Barthel index are key instruments for assessing disability and functional independence. The use of these tools ensures objective analysis of disease course, treatment efficacy, and post-stroke recovery. The purpose was to perform a comparative analysis of neurological deficit severity and functional independence in patients with acute ischemic stroke depending on carbohydrate metabolism status (normoglycemia, transient hyperglycemia, type 2 diabetes mellitus) using the NIHSS, mRS, and Barthel index. Materials and methods. A total of 124 patients with acute ischemic stroke were examined and divided into three groups: control (n = 30), transient hyperglycemia (n = 31), and type 2 diabetes mellitus (n = 63). Examination was conducted using the NIHSS at admission and discharge, mRS and Barthel index at discharge. Results. A significant reduction in NIHSS scores was observed in all groups (p < 0.001). However, patients with diabetes demonstrated higher NIHSS scores at discharge (p = 0.03), the lowest proportion of favorable outcomes according to mRS (38.1 %), and the lowest Barthel index (64.67 ± 36.30; p = 0.045 compared to the control group). In contrast, favorable outcomes were observed in 60.0 % of patients with normoglycemia and 64.6 % of those with transient hyperglycemia. Conclusions. Chronic hyperglycemia in type 2 diabetes mellitus is associated with poorer functional outcomes after ischemic stroke. Normoglycemia is linked to the most favorable prognosis, while transient hyperglycemia demonstrates an intermediate impact. Early glycemic control should be considered an essential component of therapeutic and rehabilitation strategies.</jats:p>