Comment on: Calleja et al. Insulin Resistance Is Associated With a Poor Response to Intravenous Thrombolysis in Acute Ischemic Stroke. Diabetes Care 2011;34:2413–2417

In a recent article, Calleja et al. (1) reported that insulin resistance (IR), as reflected in homeostasis model assessment of IR (HOMA-IR), is a major determinant of adverse outcomes in stroke treated with thrombolysis. Although the data are consistent with the conclusion, it is extremely important that adequate attention is given to plasma glucose concentrations, since they are known to affect outcomes even when they appear to be modestly elevated. Though the authors provide data on glucose concentrations at the time of presentation, they do not provide data on glucose and insulin concentrations prior to the …