Acute And Chronic Complications Of Diabetes
Stroke is a major cause of morbidity and premature death in patients with diabetes. The majority of cases of stroke result from thromboembolic occlusion of cerebral arteries with a smaller percentage attributable to intracerebral haemorrhage. Risk factors including obesity, hypertension and dyslipidaemia, which are commonly present in patients with type 2 diabetes, contribute to the elevated risk of stroke. Patients with diabetes tend to have stroke at a younger age compared with the non-diabetic population; this risk is especially marked in patients with type 1 diabetes. Mortality is higher and functional outcomes are generally poorer following stroke in the presence of diabetes. Primary and secondary prevention relies on a comprehensive multi-factorial approach to risk factor modification. Background Diabetes mellitus is a modifiable risk factor for stroke.[1] Approximately 20% of patients with diabetes will die as a result of stroke, making this one of the leading causes of death for this population.[2] Symptom onset tends to occur at an earlier age in the presence of diabetes and functional outcomes are worse than for non-diabetics.[2] The increase in risk of ischaemic stroke is especially evident in the under-65 age group. While overall stroke incidence and mortality in developed countries has declined in recent decades the incidence of stroke in young adults has been increasing. Diabetes and obesity have been identified as risk factors for stroke in younger adults. The elevated risk of stroke in patients with type 1 diabetes is particularly evident in the second to fourth decades of life.[3] The incidence of stroke – classically defined as an acute focal cerebral deficit with no apparent cause other than a vascular origin – is increased several-fold by the pre Continue reading >>
Amlodipine And Death/stroke Incidence
Diabetes & Heart Health There's new information about how to protect your heart. A segment of the Anglo-Scandinavian Cardiac Outcomes Trial looked at the effect of two kinds of antihypertension drugs on the heart health of people with type 2 diabetes.The results were so dramatic that the study was stopped early in order to afford all participants the benefits of what was becoming evident. Comparing the effect of taking a calcium channel blocker (amlodipine) to a beta blocker (atenolol), researchers found that amlodipine reduced the incidence of death and stroke significantly. Fatal and nonfatal strokes were reduced by 25 percent, peripheral arterial disease by 48 percent and noncoronary revascularization procedures (such as angioplasty) by 57 percent in comparison to what happened to those taking atenolol. Further questions about atenolol arose from a review of nine clinical trials on the use of beta blockers for treatment of hypertension published in the Journal of the American College of Cardiology on October 28, 2008. Most of the patients were taking atenolol. The researchers found that even though atenolol or other beta blockers lower the heart rate, they were associated with a greater risk of heart attack, stroke, heart failure and death from all causes. Scientists do stress the need for more studies before this finding is confirmed. Myths about Cholesterol If you are concerned about lowering your cholesterol levels, the first things to give up are faulty beliefs. Myth 1: You should never eat eggs if you have high cholesterol. Reality: It's true that for people with high cholesterol, limiting egg consumption is important. One egg contains 215 mg of cholesterol, and the American Heart Association says that those with heart disease should get only 200 mg a day. But p Continue reading >>
Medical Emergency Research Risk Factors For Medical Complications Of Acute Hemorrhagic Stroke
Abstract To assess the risk factors leading to medical complications of hemorrhagic stroke. We conducted an observational study in neurology, emergency and general medicine wards at a tertiary care teaching hospital in Kadapa. We recruited hemorrhagic stroke patients, and excluded the patients have evidence of trauma or brain tumor as the cause of hemorrhage. We observed the subjects throughout their hospital stay to assess the risk factors and complications. During period of 12 months, 288 subjects included in the study, 89% of them identified at least 1 prespecified risk factor for their admission in hospital and 75% of them experienced at least 1 prespecified complication during their stay in hospital. Around 47% of subjects deceased, among which 64% were females. Our study has assessed that hypertension followed by diabetes mellitus are the major risk factors for medical complications of hemorrhagic stroke. Female mortality rate was more when compared to males. Continue reading >>
Diabetes, Heart Disease, And Stroke
Having diabetes means that you are more likely to develop heart disease and have a greater chance of a heart attack or a stroke. People with diabetes are also more likely to have certain conditions, or risk factors, that increase the chances of having heart disease or stroke, such as high blood pressure or high cholesterol. If you have diabetes, you can protect your heart and health by managing your blood glucose, also called blood sugar, as well as your blood pressure and cholesterol. If you smoke, get help to stop. What is the link between diabetes, heart disease, and stroke? Over time, high blood glucose from diabetes can damage your blood vessels and the nerves that control your heart and blood vessels. The longer you have diabetes, the higher the chances that you will develop heart disease.1 People with diabetes tend to develop heart disease at a younger age than people without diabetes. In adults with diabetes, the most common causes of death are heart disease and stroke. Adults with diabetes are nearly twice as likely to die from heart disease or stroke as people without diabetes.2 The good news is that the steps you take to manage your diabetes also help to lower your chances of having heart disease or stroke. What else increases my chances of heart disease or stroke if I have diabetes? If you have diabetes, other factors add to your chances of developing heart disease or having a stroke. Smoking Smoking raises your risk of developing heart disease. If you have diabetes, it is important to stop smoking because both smoking and diabetes narrow blood vessels. Smoking also increases your chances of developing other long-term problems such as lung disease. Smoking also can damage the blood vessels in your legs and increase the risk of lower leg infections, ulcers, a 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 Stroke Prevention: A Review
Stroke Research and Treatment Volume 2012 (2012), Article ID 673187, 6 pages 1Geriatric Medicine, University of Cardiff, Cardiff CF14 4XY, UK 2Department of Internal Medicine, Hospital de la Merced, University of Seville, Seville, Spain 3Department of Neurology, Hospital de Valme, University of Seville, Seville, Spain 4Department of Internal Medicine, Hospital Clinic, University of Barcelona, Barcelona, Spain Academic Editor: Graham S. Venables Copyright © 2012 Jonathan Hewitt 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. Abstract Stroke and diabetes mellitus are two separate conditions which share multiple common threads. Both are increasing in prevalence, both are diseases which affect blood vessels, and both are associated with other vascular risk factors, such as hypertension and dyslipidemia. Abnormal glucose regulation, of which diabetes is one manifestation, is seen in up to two-thirds of people suffering from an acute stroke. Surprisingly, aggressive management of glucose after an acute stroke has not been shown to improve outcome or reduce the incidence of further strokes. More encouragingly, active management of other cardiovascular risk factors has been demonstrated to prevent stroke disease and improve outcome following a stroke in the diabetic person. Hypertension should be treated with a target of 140/80 mmHg, as a maximum. The drug of choice would be an ACE inhibitor, although the priority is blood pressure reduction regardless of the medication chosen. Lipids should be treated with a statin whatever the starting cholesterol. Antiplatelet treatment is also essential but there ar Continue reading >>
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 >>
10 Common Diabetes Complications And Tips For Prevention
Good management of diabetes and blood glucose levels can help prevent complications of diabetes. Complications of diabetes include: 1. Heart disease At every diabetes appointment, your doctor or diabetes nurse will usually check your blood pressure. Your blood cholesterol level and triglycerides should be checked at your first visit and then at least annually - and more often until target levels are achieved. A baseline ECG should also be obtained as part of a complete medical record. Tell your doctor any personal risk factors you have for heart disease and work out a prevention plan that includes weight loss when needed, regular exercise, and stress management, to help to keep your blood pressure, cholesterol and triglycerides at healthy levels. 2. Stroke Knowing the warning signs and risks of stroke can help prevent this serious condition resulting in problems for you. If you have any signs and symptoms of stroke - including sudden weakness on one side of the face or body; numbness in the face, arm or leg; difficulty speaking; trouble seeing with both eyes - call 999. If you have high blood pressure, treating it effectively reduces both your risk of having and dying from a stroke. If you smoke, quit - stopping smoking will decrease the risk of stroke. Abnormally high cholesterol levels also increase your risk of stroke. Your diet, activity level and medication can reduce your cholesterol level and reduce your risk of stroke. 3. Kidney disease (nephropathy) After an initial negative screening test, urine testing should be performed at least yearly to look for kidney damage in those with diabetes. At baseline, a creatinine blood test (kidney function test) should also be done. Your doctor or nurse will also check your blood pressure regularly since control of high blood Continue reading >>
Diabetes And Stroke 101
If you have diabetes, your risk of having a stroke is greater than that of someone without diabetes, even if you are otherwise healthy. Here's why: Diabetes can damage your blood vessels, so they are more prone to blockage. Your brain needs oxygen to survive. When you have a stroke, one or more of the blood vessels that delivers oxygen to the brain has become blocked. Also, with diabetes, the blood is thicker and more prone to clotting, thus slowing or blocking circulation. In addition, those with diabetes who suffer strokes often have a worse prognosis than those without diabetes. When the oxygen to the brain is blocked, other arteries can sometimes bypass the blockage and get enough oxygen to the brain. If you have diabetes, you may have blocked or narrow arteries that are less able to come to the rescue. How Do I Know When I'm Having a Stroke? You can improve your odds of surviving a stroke by knowing the symptoms. Signs of a stroke include sudden onset of any of the following: numbness (especially on one side, of your face, arm, or leg), paralysis in one part of the body, blurred vision or trouble swallowing, intense headache, difficulty speaking or understanding what is being said, and a brief period of unconsciousness. Call 911 as soon as possible if you or someone you are with experiences any of these symptoms. What Happens After a Stroke? If you suffer a stroke, your doctor may prescribe medication. Alternatively, your doctor may recommend surgery. Surgical options for treating a stroke include surgically removing the blockage from the carotid artery (this supplies blood to the brain) or inserting a stent into the blocked artery to hold it open and allow the blood to flow. You Can Prevent Stroke With the addition of controlling blood sugar, the tips to help prev Continue reading >>
Complications
If diabetes isn't treated, it can lead to a number of different health problems. High glucose levels can damage blood vessels, nerves and organs. Even a mildly raised glucose level that doesn't cause any symptoms can have damaging effects in the long term. Heart disease and stroke If you have diabetes, you're up to five times more likely to develop coronary heart disease (CHD) or have a stroke. Prolonged, poorly controlled blood glucose levels increase the likelihood of developing atherosclerosis (furring and narrowing of your blood vessels). This may result in a poor blood supply to your heart, causing angina (a dull, heavy or tight pain in the chest). It also increases the chance that a blood vessel in your heart or brain will become completely blocked, leading to a heart attack or stroke. Nerve damage High blood glucose levels can damage the tiny blood vessels of your nerves. This can cause a tingling or burning pain that spreads from your fingers and toes up through your limbs. It can also cause numbness, which can lead to ulceration of the feet. Damage to the peripheral nervous system (the nervous system outside the brain and spinal cord) is known as peripheral neuropathy. If the nerves in your digestive system are affected, you may experience nausea, vomiting, diarrhoea or constipation. Diabetic retinopathy Diabetic retinopathy is where the retina, the light-sensitive layer of tissue at the back of the eye, becomes damaged. The retina needs a constant supply of blood, which it receives through a network of tiny blood vessels. Over time, a persistently high blood sugar level can damage these blood vessels and affect your vision. Annual eye checks are usually organised by a regional photographic unit. If significant damage is detected, you may be referred to a docto Continue reading >>
Recommended Blood Pressure Targets For Diabetics May Raise Stroke, Heart Attack Complications: Study
Home » Heart Health » Blood Pressure » Recommended blood pressure targets for diabetics may raise stroke, heart attack complications: Study Recommended blood pressure targets for diabetics may raise stroke and heart attack complications. The Swedish National Board of Health and Welfare recently raised the recommended blood pressure readings for patients with diabetics from 130 mm Hg to 140 mm Hg. The revision is based on the premise that high blood pressure is not the only problem for diabetics, and low blood pressure – below 130 mm Hg – poses a threat as well. However, the researchers found that the lower the blood pressure the fewer the cases of stroke and heart attack there were. One of the researchers Staffan Björck explained, “We believe that the recommendation to accept higher blood pressure in patients with diabetes is incorrect. It may lead to more cases of stroke and myocardial infarction in this patient group.” The study was based on data collected from the National Diabetes Register, the Patient Register, and the Prescribed Drug Register. Data from over 187,000 patients was collected during a five-year period. Primary author of the study Samuel Adamsson Eryd explained, “What we have seen in our study is that, if we exclude individuals with previous severe disease, then the connection between low blood pressure and increased risk of stroke and myocardial infarction disappears.” “If patients with diseases that can cause low blood pressure are also included in a study, the overall interpretation might be that low blood pressure leads to more cardiovascular disease,” added Björck. Blood pressure is a worldwide problem, so the guidelines for healthy blood pressure become an international discussion. Because of the large size of this study, it Continue reading >>
Cardiovascular Disease & Diabetes
The following statistics speak loud and clear that there is a strong correlation between cardiovascular disease (CVD) and diabetes. At least 68 percent of people age 65 or older with diabetes die from some form of heart disease; and 16% die of stroke. Adults with diabetes are two to four times more likely to die from heart disease than adults without diabetes. The American Heart Association considers diabetes to be one of the seven major controllable risk factors for cardiovascular disease. Why are people with diabetes at increased risk for CVD? Diabetes is treatable, but even when glucose levels are under control it greatly increases the risk of heart disease and stroke. That's because people with diabetes, particularly type 2 diabetes, may have the following conditions that contribute to their risk for developing cardiovascular disease. High blood pressure (hypertension) High blood pressure has long been recognized as a major risk factor for cardiovascular disease. Studies report a positive association between hypertension and insulin resistance. When patients have both hypertension and diabetes, which is a common combination, their risk for cardiovascular disease doubles. Abnormal cholesterol and high triglycerides Patients with diabetes often have unhealthy cholesterol levels including high LDL ("bad") cholesterol, low HDL ("good") cholesterol, and high triglycerides. This triad of poor lipid counts often occurs in patients with premature coronary heart disease. It is also characteristic of a lipid disorder associated with insulin resistance called atherogenic dyslipidemia, or diabetic dyslipidemia in those patients with diabetes. Learn more about cholesterol abnormalities as they relate to diabetes. Obesity Obesity is a major risk factor for cardiovascular disease Continue reading >>
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Cerebrovascular Complications Of Diabetes: Focus On Stroke
Go to: Abstract Cerebrovascular complications make diabetic patients 2–6 times more susceptible to a stroke event and this risk is magnified in younger individuals and in patients with hypertension and complications in other vascular beds. In addition, when patients with diabetes and hyperglycemia experience an acute ischemic stroke they are more likely to die or be severely disabled and less likely to benefit from the one FDA-approved therapy, intravenous tissue plasminogen activator. Experimental stroke models have revealed that chronic hyperglycemia leads to deficits in cerebrovascular structure and function that may explain some of the clinical observations. Increased edema, neovascularization and protease expression as well as altered vascular reactivity and tone may be involved and point to potential therapeutic targets. Further study is needed to fully understand this complex disease state and the breadth of its manifestation in the cerebrovasculature. Keywords: cerebral vasculature, diabetes, hemorrhage, ischemia, stroke, targets Go to: The steadily increasing prevalence of obesity in developed nations has contributed to the alarming rate of diagnoses of type 2 diabetes (T2D) and prediabetes, even in children.1 In addition, there is an equally alarming increase in the number of younger patients diagnosed with type 1 diabetes (T1D).2,3,4 Given the mortality and morbidity due to cardiovascular diseases (CVD) associated with diabetes, this increase in the incidence of diabetes will have an avalanche effect in health care. Hyperglycemia ravages all vascular beds in the human body, and in the brain, this has devastating consequences. A growing body of literature indicates that the cerebrovascular sequelae of diabetes may play an important role in the pathogenesis o Continue reading >>
Preventing Stroke
Having a stroke can have devastating consequences. A stroke occurs when the flow of blood to the brain is disrupted. Brain tissue that is deprived of blood for more than three minutes will begin to die. Emergency treatment should be started as soon as possible and ideally within three hours after the onset of stroke symptoms. The longer the brain goes without fresh blood and oxygen, the greater the damage. Depending on what part of the brain is affected, a stroke can cause a wide range of physical and mental disabilities. Unfortunately, having diabetes raises the risk of having a stroke. But like many potential diabetes complications, stroke is not inevitable, and the risk of having one can be lowered by identifying and addressing any risk factors you may have besides diabetes. You may already be aware of some of your risks, but if you’re not sure about any of the items listed here, ask your doctor whether you have these risk factors. Uncontrollable risk factors Some of the risk factors for stroke cannot be changed by your actions. Those that cannot include the following: Age. The likelihood of having a stroke increases after age 55. Sex. Stroke is more common in men than women. Women, however, are more likely to die of stroke. Heredity. People who have a family history of stroke are more likely to have a stroke than someone whose family has not had strokes. African-Americans have a higher risk of stroke than other races and a much higher risk of death from stroke, in part because of their higher rates of diabetes, hypertension (high blood pressure), obesity, and smoking. Prior stroke or heart attack. People who have previously had a stroke or heart attack are at greater risk of having a stroke. Mini-stroke. People who have had a transient ischemic attack (TIA), or a Continue reading >>
Diabetes Warning: High Blood Sugar Can Cause This Deadly Side-effect Years After Diagnosis
If diabetes goes untreated - or is not properly managed - it can cause a number of serious complications. According to the NHS, this is because high glucose levels can damage blood vessels, nerves and organs. The condition can raise risk of heart disease and stroke. Scientists had been unsure exactly why raised cholesterol levels was a long-term diabetes complication - until now. Researchers discovered that inflammation in the liver leads to increased cholesterol levels in sufferers, and therefore raises their risk of vascular diseases. A study published in the journal Cell Reports discovered that inflammation in the liver leads to increased cholesterol levels in sufferers, and therefore raises their risk of vascular diseases. The research reveals a previously unknown mechanism. Such diseases are one of the main reason for hospitalisations and deaths among diabetes patients. “Even if blood glucose levels are well controlled, some people with diabetes have a higher risk of long-term complications,” said, Dr Mauricio Berriel Diaz, metabolism researcher and deputy director of the Institute for Diabetes and Cancer (IDC) at Helmholtz Zentrum München. Fri, August 19, 2016 Diabetes is a common life-long health condition. There are 3.5 million people diagnosed with diabetes in the UK and an estimated 500,000 who are living undiagnosed with the condition. “We wanted to understand the underlying cause for this.” In the study, the researchers focused on inflammatory processes known to occur in many metabolic disorders such as type 2 diabetes and obesity. These processes were also known to contribute significantly to long-term complications. They study authors concentrated specifically on the liver. “Our data suggest that the liver plays a key role in the development of Continue reading >>
