BackgroundThe　role　of　high　fasting　plasma　glucose　(HFPG)　in　ischaemic　stroke　(IS)　has　become　increasingly　prominent.　Our　study　aimed　to　assess　the　global　and　regional　distribution　of　the　burden　of　IS　attributable　to　HFPG　(IS-HFPG)　and　to　predict　the　disease　burden　of　IS-HFPG　to　2041.MethodsThis　study　extracted　the　data　on　the　burden　of　IS-HFPG,　including　the　number　and　age-standardized　rate　of　deaths　and　disability-adjusted　life　years　(DALYs)　from　the　Global　Burden　of　Disease　Study　(GBD)　2021.　Joinpoint　analysis　was　used　to　assess　trends　in　IS-HFPG　burden　between　1990　and　2021.　Further　analyses　were　stratified　by　region,　sex,　and　age　groups.ResultsIn　2021,　the　number　of　deaths　and　DALYs　related　to　IS-HFPG　reached　0.65　million　and　12.37　million,　respectively.　From　1990　to　2021,　the　global　age-standardized　mortality　rate　(ASMR)　and　DALY　(ASDR)　for　IS-HFPG　declined,　with　an　Average　Annual　Percentage　Change　(AAPC)　of　-0.96　(95%　CI:　-1.06,　-0.86)　and　-0.72　(95%　CI:　-0.81,　-0.62),　respectively.　Regionally,　the　ASMR　and　ASDR　were　highest　in　High-middle　SDI　and　lowest　in　High　SDI.　ASMR　were　higher　for　males　than　for　females,　with　rates　of　9.43　per　100,000　(95%　UI:　7.31,　11.75)　and　7.07　per　100,000　(95%　UI:　5.35,　8.96),　respectively.　Age-stratified　analysis　indicates　that　the　elderly　population,　particularly　those　over　70　years　old,　bears　the　heaviest　burden.ConclusionsOur　research　indicates　that　the　global　ASMR　and　ASDR　attributable　to　IS-HFPG　has　a　declining　trend.　However,　developing　regions　confront　a　burden　of　mortality　and　disability　associated　with　IS-HFPG.　Notably,　male　and　the　elderly　are　the　primary　demographics　affected　by　IS-HFPG.　Our　study　underscores　the　necessity　for　regions　to　formulate　targeted　prevention　and　treatment　strategies　that　address　the　specific　needs　of　diverse　populations,　particularly　in　low-　and　middle-income　countries.