Relationship Between Diabetes And Ischemic Stroke : Analysis Of Diabetes-related Risk Factors For Stroke And Of Specific Patterns Of Stroke Associated With Diabetes Mellitus
Relationship between Diabetes and Ischemic Stroke : Analysis of Diabetes-Related Risk Factors for Stroke and of Specific Patterns of Stroke Associated with Diabetes Mellitus @inproceedings{Tuttolomondo2015RelationshipBD, title={Relationship between Diabetes and Ischemic Stroke : Analysis of Diabetes-Related Risk Factors for Stroke and of Specific Patterns of Stroke Associated with Diabetes Mellitus}, author={Antonino Tuttolomondo and Carlo Maida and Rosario Maugeri and Gerardo Iacopino and Ant{\'o}nio Pinto}, year={2015}} Antonino Tuttolomondo , Carlo Maida , +2 authors Antnio Pinto Diabetes and ischemic stroke are common diseases that frequently occurring together. Among patients with diabetes mellitus several factors contribute in varying degrees to the overall cerebrovascular risk including hyperglycemia, vascular risk factors such as hypertension and dyslipidemia and also genetic, demographic, and lifestyle factors and several studies have shown that people with diabetes have approximately twice the risk of ischemic stroke compared with those without diabetes. TheCONTINUE READING Continue reading >>
Stroke In Diabetic Patients
Stroke is the leading cause of disability and the second most frequent cause of death worldwide. On the one hand, diabetic patients have a 1.5 to 3-times higher risk of stroke, especially cerebral infarction, than non-diabetic subjects. This excess risk, which is particularly pronounced in younger individuals and women, can be reduced by effective therapeutic strategies aimed at improving glycaemic control and the management of co-morbid conditions such as hypertension and dyslipidaemia. On the other hand, the prevalence of diabetes in stroke patients is between 10 and 20%, and has been increasing over the last 20 years, probably in response to rising rates of overweight and obesity in the general population and other factors such as a sedentary lifestyle. Even though diabetes has long been considered a specific risk factor of lacunar stroke, recent epidemiological studies have demonstrated that this risk factor was in fact not associated with any ischemic stroke subtype. Finally, it has been suggested that diabetic stroke patients have poorer motor and functional outcomes, and are at a higher risk of dementia, recurrent stroke and death. The full text of this article is available in PDF format. Les accidents vasculaires cérébraux représentent la première cause de handicap et la seconde cause de décès à travers le monde. Les patients diabétiques ont un risque 1,5 à 3 fois plus élevé d’accident vasculaire cérébral, et en particulier d’infarctus cérébral, que les non diabétiques. Cet excès de risque, qui est particulièrement marqué chez les sujets jeunes et les femmes, peut être réduit par des stratégies thérapeutiques efficaces qui visent au contrôle glycémique et à la prise en charge des co-morbidités telles que l’hypertension artériell Continue reading >>
Full Article: Stroke Prognosis In Diabetes Mellitus: New Insights But Questions Remain
Click to increase image sizeClick to decrease image size Diabetes mellitus accelerates the clinical course of atherosclerosis and increases both cardiovascular morbidity and mortality [1] . Besides hypertension and dyslipidemia, diabetes is a well-known independent risk factor for coronary heart disease and ischemic stroke, particularly atherothrombotic infarction and lacunes [2] . In a classical autopsy study of acute cerebrovascular accidents in diabetes, cerebral small-vessel disease was 2.5-times more frequent in diabetes [3] . In clinical series of lacunar infarctions, the incidence of diabetes varied between 11 and 29% [47] . Diabetes is not only an independent risk factor for lacunar infarction, especially in patients with multiple lacunar infarcts [7] , but the presence of diabetes is also associated with worse functional recovery in these patients [8] . In a recent study, diabetes and hypertension were independent factors related to the recurrence of lacunar stroke in patients who had suffered from a previous lacunar stroke [9] . Moreover, cognitive impairment was observed in 16% of patients with a first lacunar stroke recurrence and in 40% of those with multiple recurrent lacunes [9] . Although the deleterious effect of diabetes on cardiovascular morbimortality has been investigated extensively, a limited number of prospective studies have examined in-hospital mortality in patients with ischemic stroke and diabetes. In the study by Jorgensen et al., in-hospital mortality in stroke patients with diabetes was 24% compared with 17% in those without diabetes; diabetes increased the relative death risk by 1.8 [10] . The reason for the increased early death and worse prognosis associated with cerebral infarction in diabetic patients is not well understood. Diabetic Continue reading >>
Frontiers | Interaction Of Sex And Diabetes On Outcome After Ischemic Stroke | Neurology
Front. Neurol., 13 April 2018 | Interaction of Sex and Diabetes on Outcome After Ischemic Stroke 1Universitat Pompeu Fabra and Universitat Autnoma de Barcelona, Barcelona, Spain 2Servei de Neurologia, IMIM-Hospital del Mar, Barcelona, Spain 3Departament de Medicina, Universitat Autnoma de Barcelona, Barcelona, Spain Background: The relationship between ischemic stroke (IS), diabetes mellitus (DM), and sex is intriguing. The aim of this study was to assess the effect modification of sex in the association between DM and short- and long-term disability and mortality in first-ever IS patients. Methods: In a retrospective, observational, hospital-based study of a prospective series including first-ever IS patients from January 2006 until July 2011, differences in 3-month and 5-year mortality, and disability between diabetic and non-diabetic patients [modified Rankin Scale (mRS) from 3 to 5] were analyzed by sex. Results: In total, 933 patients (36.3% with DM, 50.5% women) were included. Overall 3-month and 5-year mortality were 150 (16.1%) and 407 (44.1%), respectively. Adjusted for age, previous mRS, and stroke severity, patients with DM had significantly higher 3-month disability [hazard ratio (HR): 1.49 (95% confidence interval (CI): 1.391.70), p < 0.0001], 5-year disability [HR: 1.41 (95% CI: 1.071.86), p = 0.015], and 5-year mortality [HR: 1.48 (95% CI: 1.201.81), p < 0.0001], compared with the non-DM group. Compared with non-DM women, women with diabetes had worse 3-month disability [HR: 1.81 (95% CI: 1.332.46), p < 0.0001] and 5-year mortality [HR: 1.72 (95% CI: 1.302.20), p < 0.0001], and a trend for 5-year disability [HR: 1.40 (95% CI: 0.992.09), p = 0.057]. In men, DM had an effect on 3-month disability [HR: 1.45 (95% CI: 1.071.96), p = 0.018], a trend for 5-year Continue reading >>
Diabetes Worsens The Outcome Of Acute Ischemic Stroke
Volume 69, Issue 3 , September 2005, Pages 293-298 Diabetes worsens the outcome of acute ischemic stroke Author links open overlay panel Minna M.Kaarisaloa To characterize acute stroke events in diabetic patients in a population-based stroke register and to determine the influence of diabetes on the outcome of acute stroke. Four thousand three hundred and ninety patients were recorded in the FINMONICA and FINSTROKE registers after their first ischemic stroke from 1990 to 1998. We followed mortality and stroke outcome for up to 4 weeks after the onset of acute stroke. Of the 4390 patients who had had an ischemic stroke, 43.6% were male and 25.1% (1103) had diabetes. Their mean age was 72.4 (S.D. 12.0) years and this was similar in patients with and without diabetes (72.9 years versus 72.3 years, p=0.18). Subjects with diabetes were more likely to be hypertensive (55% versus 38%, p<0.001) and have a history of myocardial infarction (20% versus 16%, p<0.001) than the non-diabetic stroke patients. Mortality at 4 weeks from the onset was higher in diabetic than in non-diabetic patients (20.0% versus 16.9% p=0.020). At day 28 after the stroke attack, diabetic patients were more likely to be disabled when compared with non-diabetic subjects (43.3% versus 33.5%, p<0.001). Using logistic regression analysis, adjusted for age-group, sex, previous medical history (MI, AF or TIA), diabetes was found to be a significant predictor of disability after stroke (OR=1.51, 95% CI 1.271.81). Diabetes, which affected one-fourth of the ischemic stroke patients on our register, was associated with a higher risk of death and disability after the onset of stroke. Preventing diabetes in the elderly population improves the short-term prognosis of acute ischemic stroke. Continue reading >>
Relationship Between Diabetes And Ischemic Stroke: Analysis Of Diabetes- Related Risk Factors For Stroke And Of Specific Patterns Of Stroke Associated With Diabetes Mellitus
1Internal Medicine Ward,Dipartimento Biomedico di Medicina Interna e Specialistica (Di.Bi.M.I.S), Università degli Studi di Palermo (Italy) 2Neurosurgery Unit, Department of Experimental Medicine and Clinical Neurosciences, University of Palermo, Palermo, Italy Citation: Tuttolomondo A, Maida C, Maugeri R, Iacopino G, Pinto A (2015) Relationship between Diabetes and Ischemic Stroke: Analysis of Diabetes-Related Risk Factors for Stroke and of Specific Patterns of Stroke Associated with Diabetes Mellitus. J Diabetes Metab 6:544. doi:10.4172/2155-6156.1000544 Copyright: © 2015 Tuttolomondo A, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Visit for more related articles at Journal of Diabetes & Metabolism Abstract Diabetes and ischemic stroke are common diseases that frequently occurring together. Among patients with diabetes mellitus several factors contribute in varying degrees to the overall cerebrovascular risk including hyperglycemia, vascular risk factors such as hypertension and dyslipidemia and also genetic, demographic, and lifestyle factors and several studies have shown that people with diabetes have approximately twice the risk of ischemic stroke compared with those without diabetes. The association between ischemic stroke and diabetes is bidirectional and it is not limited to acute ischemic stroke since diabetes may contribute to a more insidious brain damage represented by lacunar infarcts increasing the risk of dementia and leading to a steeper decline in cognitive function. The higher cerebrovascular risk profile of subjects with diabetes mellitus emphasizes the Continue reading >>
Diabetes And Ischaemic Stroke: A Deadly Association
This editorial refers to Diabetes and long-term outcomes of ischaemic stroke: findings from Get With The Guidelines-Stroke, by J.B. Echouffo-Tcheugui et al., on page 2376. Diabetes increases the risk for acute cardiovascular events. With increasing population aging, the diabetes and cardiovascular disease (CVD) dyad will inevitably become a healthcare emergency worldwide. While much attention has traditionally been devoted to ischaemic heart disease, there is a need to refocus on other (CVD) manifestations. According to the most recent statistical reports, stroke, taken separately from other CVD, ranks as the fifth most common cause of death.1 Furthermore, stroke is a disaster in terms of disability... Published on behalf of the European Society of Cardiology. All rights reserved. The Author(s) 2018. For permissions, please email: [email protected] This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model ( Continue reading >>
The Link Between Stroke And Diabetes
While multiple studies say diabetes puts you at risk of conditions such as heart disease, stroke, and kidney failure, a healthy lifestyle and insulin treatments can help keep your risk low. In a stroke, one of the many blood vessels that supply your brain with oxygen becomes damaged or blocked. If the blood flow is cut off for more than 3 to 4 minutes, that part of your brain begins to die. There are two types of strokes: Hemorrhagic strokes are caused by a ruptured artery. Ischemic strokes result from a blocked artery. Diabetes can also make it harder for your body to respond to a stroke. When your oxygen supply is cut off, other arteries can usually serve as a bypass. But if you have diabetes, those vessels may be hardened or clogged with plaque, a condition known as atherosclerosis. This makes it harder for blood to get to your brain. High blood pressure is the leading risk factor for stroke. Others include smoking cigarettes and high levels of LDL ("bad") cholesterol. A stroke is an emergency whether you have diabetes or not. If you or someone near you has any of these symptoms, call 911 at once. Sudden numbness or weakness in the face, arm, or leg (especially on one side of the body) Trouble speaking or understanding words or simple sentences Sudden trouble swallowing Dizziness, loss of balance, or lack of coordination Brief loss of consciousness Sudden inability to move part of the body (paralysis) Sudden, unexplainable, and intense headache One treatment for ischemic stroke is a clot-buster drug called tPA, which must be taken within the first 3 hours after stroke symptoms begin. It dissolves the clot that has clogged an artery and can restore blood flow to brain tissue. But this drug isn’t for all people who have an ischemic stroke, especially if you've had ma Continue reading >>
Type 2 Diabetic Patients With Ischemic Stroke: Decreased Insulin Sensitivity And Decreases In Antioxidant Enzyme Activity Are Related To Different Stroke Subtypes
Type 2 Diabetic Patients with Ischemic Stroke: Decreased Insulin Sensitivity and Decreases in Antioxidant Enzyme Activity Are Related to Different Stroke Subtypes Aleksandra Jotic ,1 Nadezda Covickovic Sternic ,2 Vladimir S. Kostic ,2 Katarina Lalic ,1 Tanja Milicic ,1 Milija Mijajlovic ,2 Ljiljana Lukic ,1 Milorad Civcic ,1 Emina Colak ,3 Marija Macesic ,1 Jelena P. Seferovic ,1 Sandra Aleksic ,1and Nebojsa M. Lalic 1 1Clinic for Endocrinology, Diabetes and Metabolic Disorders, Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Dr Subotica 13, 11000 Belgrade, Serbia 2Clinic for Neurology, Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Dr Subotica 6, 11000 Belgrade, Serbia 3Institute of Medical Biochemistry, Clinical Centre of Serbia, Pasterova 2, 11000 Belgrade, Serbia Received 14 May 2013; Accepted 22 May 2013 Copyright 2013 Aleksandra Jotic et al. This is an open access article distributed under the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. We analyzed (a) insulin sensitivity (IS) and (b) glutathione peroxidase (GSH-Px), glutathione reductase (GR), and superoxide dismutase (SOD) antioxidant enzyme activity in type 2 diabetic (T2D) patients with atherothrombotic infarction (ATI) (group A), lacunar infarction (LI) (B), or without stroke (C) and in nondiabetics with ATI (D), LI (E), or without stroke (F). ATI and LI were confirmed by brain imaging IS levels were determined byminimal model (Si index), and the enzyme activity by spectrophotometry. In T2D patients, Si was lower in A and B versusC ( This work was funded by projects 175097 from the Ministry of Science, Republic of Serbia. T. Ohira, E. Shahar, Continue reading >>
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The Treatment Of Diabetes After An Acute Ischaemic Stroke
Diabetes and ischaemic stroke are common conditions that often co-occur. The relationship between diabetes and stroke is bidirectional. On the one hand, people with diabetes have a more than two-fold increased risk of ischaemic stroke compared to people without diabetes.1 On the other hand, acute stroke can give rise to abnormalities in glucose metabolism, which in turn may affect outcome.2 In the current review, which is based on a recent paper from our group in the Lancet Neurology,3 we describe the management of diabetes both in the acute stage of stroke and in the longer term, with regard to secondary prevention. Diabetes and the Risk of Stroke A recent meta-analysis of prospective studies including 530,083 participants reported a hazard ratio for ischaemic stroke of 2.3 (95 % confidence interval [CI] 2.0–2.7) in people with versus people without diabetes.1 Considering that the estimated world-wide prevalence of diabetes in adults is around 10 %, this implies that one in eight to nine cases of stroke is attributable to diabetes. Diabetes is associated with different aetiological subtypes of ischaemic stroke, including lacunar and athero- and cardioembolic strokes.4–6 Moreover, the risk of atrial fibrillation, the major cause of thromboembolic stroke, is increased by 40 % in diabetes.7 Diabetes-associated risk factors for stroke include diabetes-specific factors (e.g. hyperglycaemia) and vascular risk factors (e.g. hypertension, dyslipidaemia), but also genetic, demographic, and lifestyle factors. The contribution of these factors, many of which are strongly interrelated, is likely to differ according to diabetes type and age. Hyperglycaemia and Stroke Outcome Hyperglycaemia occurs in 30–40 % of patients with an acute ischaemic stroke.2,8 The majority of these Continue reading >>
Time Trends In Ischemic Stroke Among Type 2 Diabetic And Non-diabetic Patients: Analysis Of The Spanish National Hospital Discharge Data (2003-2012)
Click through the PLOS taxonomy to find articles in your field. For more information about PLOS Subject Areas, click here . Time Trends in Ischemic Stroke among Type 2 Diabetic and Non-Diabetic Patients: Analysis of the Spanish National Hospital Discharge Data (2003-2012) Affiliation Medicine Department, Hospital Universitario Infanta Leonor, Madrid, Spain Contributed equally to this work with: Nuria Muoz-Rivas, Manuel Mndez-Bailn, Valentn Hernndez-Barrera, Rodrigo Jimnez-Garca, Ana Lpez-de-Andrs Affiliation Medicine Department, Hospital Clnico San Carlos, Madrid, Comunidad de Madrid, Spain Contributed equally to this work with: Nuria Muoz-Rivas, Manuel Mndez-Bailn, Valentn Hernndez-Barrera, Rodrigo Jimnez-Garca, Ana Lpez-de-Andrs Affiliation Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Alcorcon, Comunidad de Madrid, Spain These authors also contributed equally to this work. Affiliation Medicine Department, Hospital Gregorio Maraon, Comunidad de Madrid, Spain Contributed equally to this work with: Nuria Muoz-Rivas, Manuel Mndez-Bailn, Valentn Hernndez-Barrera, Rodrigo Jimnez-Garca, Ana Lpez-de-Andrs Affiliation Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Alcorcon, Comunidad de Madrid, Spain These authors also contributed equally to this work. Affiliation Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Alcorcon, Comunidad de Madrid, Spain These authors also contributed equally to this work. Affiliation Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Alcorcon, Comunidad de Madrid, Spai Continue reading >>
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Diabetes And Stroke
Tweet Stroke is a condition in which blood supply to be the brain is affected. A stroke can sometimes lead to permanent damage including communication problems, paralysis and visual problems. The risk factors of stroke are similar to the risk factors for heart problems. Statistically, people with diabetes have a higher risk of dying from heart disease and stroke than the general population. By maintaining stable blood glucose, blood pressure and cholesterol, people with diabetes can increase their chances of preventing a stroke. What is a stroke? Stroke occurs when blood supply to the brain is interrupted and brain tissue is damaged. The two main types of stroke are: Ischaemic - where a blood clot forms in the brain. This accounts for about 8 out of 10 instances of stroke. Haemorrhagic - whereby a blood vessel in the brain bursts and causes a brain haemorrhage. Stroke can be especially damaging physically, but may also cause mental problems with thought or speech. What are stroke symptoms? The warning signs of a stroke are given the acronym FAST: Face - stroke will often affect muscles on one side of the face causing the mouth or eyes to droop down in contrast with the unaffected side Arms - a person having had a stroke may be unable to hold up one of their arms Speech - slurred speech may be a sign of a stroke Time - refers to the need for urgent action, call 999 immediately if one or more of the symptoms are present Other symptoms of a stroke may include: Sudden numbness or weakness on one side of the body Confusion Trouble seeing Dizziness Loss of balance Double vision Severe headache Sometimes people may experience a stroke without being fully aware that they have had one. This kind of stroke is called a transient ischaemic attack (TIA) and is sometimes referred to Continue reading >>
Prediction Of Outcome In Diabetic Acute Ischemic Stroke Patients: A Hospital-based Pilot Study Report
Abstract Background: Demographic and clinical characteristics are known to influence the outcome in acute ischemic stroke (AIS) patients. Purpose: This study is aimed at evaluating short- and long-term outcomes in diabetic AIS patients. In addition, the study also evaluates the impact of diabetes on the performance of indigenously reported biomarker, inter-alpha-trypsin inhibitor heavy chain 4 (ITIH4) and known biomarkers, neuron-specific enolase (NSE) and glial-derived S-100 beta beta protein (S-100ββ). Methods: This study was performed on 29 diabetes and 75 non-diabetes AIS patients. Outcome of AIS patients was analyzed by using modified Rankin scale at discharge, then at 12 and 18 months after discharge. Based on the obtained scores, patients were classified as improved group (scales 1-3) and dependent/expired group (scales 3-6). Blood samples were collected during admission and at discharge/expired time. Levels of NSE, S100ββ, and ITIH4 were analyzed in all samples. Results: On discharge, frequencies of dependent/expired outcome were 4/29 (14%) and 19/75 (17%) in diabetic and non-diabetic AIS patients. However, follow-up outcome at 12 and 18 months showed higher dependent/expired cases of 43 and 41% among diabetic AIS patients compared to 27 and 21% in non-diabetic patients. Multivariate analysis revealed that diabetes is an independent risk factor for dependent/expired outcome in AIS patients (OR 0.484 (at discharge); 1.307 (at 12 months) and 1.675 (at 18 months)). NSE, S100ββ, and ITIH4 showed a differential expression in both the outcome groups of AIS patients, irrespective of diabetes. Conclusion: Diabetes increases the risk of dependent/expired outcome in AIS patients. Also, serum NSE, S100ββ, and ITIH4 are independent biomarkers for prognosis of outcom Continue reading >>
Stroke: Diabetes And Other Risk Factors
Diabetes can increase your risk for many health conditions, including stroke. In general, people with diabetes are 1.5 times more likely to have a stroke than people without diabetes. People with diabetes are often left with too much sugar in their blood. That’s because their body is often unable to maintain the delicate balance that insulin plays in helping blood cells create energy from sugar. Over time, this excess sugar can lead to the buildup of clots or fat deposits inside vessels that supply blood to the neck and brain. If these deposits grow, they can cause a narrowing of the blood vessel wall or even a complete blockage. When blood flow to your brain stops for any reason, a stroke occurs. Stroke is a condition in which blood vessels in the brain are damaged. Strokes are characterized by a number of factors, including where in the brain blood vessels have been damaged and what event actually caused the damage. The main types of stroke are ischemic stroke, hemorrhagic stroke, and transient ischemic attack (TIA). Ischemic stroke Ischemic stroke is the most common type of stroke. It occurs when an artery that supplies oxygen-rich blood to the brain is blocked, most often by a blood clot. About 87 percent of strokes are ischemic strokes. Hemorrhagic stroke Hemorrhagic stroke occurs when an artery in the brain leaks blood or ruptures. Approximately 15 percent of strokes are hemorrhagic strokes. Hemorrhagic strokes can be very serious, and are responsible for about 40 percent of stroke-related deaths. Transient ischemic attack (TIA) A TIA is sometimes called a ministroke because the blood flow to the brain is blocked for a minute or so. Rarely, it can be blocked for more than 5 minutes. A TIA is an ischemic stroke, but a very short-lived one. You shouldn’t ignore, Continue reading >>
Diabetes And Stroke: Part One—risk Factors And Pathophysiology
Abstract Diabetes is a major risk factor for stroke and is associated with an increase in overall stroke mortality. The metabolic syndrome associated with insulin resistance is also a significant risk factor for stroke. The etiology of stroke in diabetics is frequently microvascular disease from fibrinoid necrosis, which causes small subcortical infarcts designated as lacunar strokes. Diabetics also have an increased incidence of large vessel intracranial vascular disease. Although strict control of blood sugar has not been shown to reduce the overall incidence of stroke in diabetics, careful management of other associated risk factors, particularly hypercholesterolemia and hypertension, are imperative for the prevention of stroke in diabetic patients. Preview Unable to display preview. Download preview PDF. Continue reading >>
