Inclusion Criteria- Patients aged > 18 years presenting to the Emergency Department with symptoms of acute ischemic stroke will be included for study.
- Acute stroke patients with normal blood glucose levels and patients with fingerstick blood glucose level of greater than or equal to 130 mg/dl will be eligible for study.
- Acute Stroke will be defined as an acute disturbance of cerebral function of presumed vascular origin causing a neurological deficit of less than 24 hours duration.
- Patients must have an NIH Stroke Scale Score of 4 to 23. Patients awakening with symptoms of stroke will be considered to have had their stroke at the time when last awake without symptoms.
Exclusion Criteria- Patients presenting after 24 hours of symptom onset. When the actual time of onset is unknown, the time when last observed to be symptom-free will be used.
- Patients with NIH scale of less than 4 or greater than 23.
- Complete or substantial resolution of symptoms before randomization.
- Patients with a previously disabling stroke (modified Rankin score > 3)
- Patients with other systemic disease such as infection (eg pneumonia, etc)
- Patients with hemorrhage visualized on CT.
- Patients who are unwilling or unable to give informed consent, or for whom a legally authorized representative is not able to consent.
- Pregnant patients.