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Review
. 2016 Apr;351(4):380-6.
doi: 10.1016/j.amjms.2016.01.011.

Diabetes and Stroke: Epidemiology, Pathophysiology, Pharmaceuticals and Outcomes

Rong Chen  1 , Bruce Ovbiagele  2 , Wuwei Feng  3
Affiliations
Review

Diabetes and Stroke: Epidemiology, Pathophysiology, Pharmaceuticals and Outcomes

Rong Chen et al. Am J Med Sci. 2016 Apr.

Abstract

There has been a significant increase in obesity rates worldwide with the corresponding surge in diabetes. Diabetes causes various microvascular and macrovascular changes often culminating in major clinical complications, 1 of which, is stroke. Although gains have been made over the last 2 decades in reducing the burden of stroke, the recent rise in rates of diabetes threatens to reverse these advances. Of the several mechanistic stroke subtypes, individuals with diabetes are especially susceptible to the consequences of cerebral small vessel diseases. Hyperglycemia confers greater risk of stroke occurrence. This increased risk is often seen in individuals with diabetes and is associated with poorer clinical outcomes (including higher mortality), especially following ischemic stroke. Improving stroke outcomes in individuals with diabetes requires prompt and persistent implementation of evidence-based medical therapies as well as adoption of beneficial lifestyle practices.

Keywords: Diabetes; Hyperglycemia; Outcomes; Stroke; Stroke prevention.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

FIGURE 1
FIGURE 1
Possible mechanisms of stroke in individuals with diabetes.
FIGURE 2
FIGURE 2
Microvascular and macrovascular stroke complications of diabetes. Patient A with history of uncontrolled diabetes (glucose is 490 mg/dL and hemoglobin A1C is 10.5% at presentation) and smoking presented with an occlusion of right ICA extending to right MCA causing acute infarct (A, arrow). Subsequently, patient A developed malignant MCA syndrome due to severe swelling and received hemicraniectomy despite the fact this patient received tPA in the first place (B). Patient B with history of uncontrolled diabetes (glucose is 434 mg/dL and hemoglobin A1C is 11.3% at presentation) presented with acute intracerebral hematoma in the left genu of internal capsule and medial aspect of left thamalus (C) and acute ischemic stroke (lacunar infarct) in the left thalamus(D). ICA, internal carotid artery; MCA, middle cerebral artery.
See this image and copyright information in PMC

References

    1. Heidenreich PA, Trogdon JG, Khavjou OA, et al. Forecasting the future of cardiovascular disease in the United States: a policy statement from the American Heart Association. Circulation. 2011;123:933–944. - PubMed
    1. Putaala J, Liebkind R, Gordin D, et al. Diabetes mellitus and ischemic stroke in the young: clinical features and long-term prognosis. Neurology. 2011;76:1831–1837. - PubMed
    1. O'Donnell MJ, Xavier D, Liu L, et al. Risk factors for ischaemic and intracerebral haemorrhagic stroke in 22 countries (the INTERSTROKE study): a case-control study. Lancet. 2010;376:112–123. - PubMed
    1. Collaboration TERF. Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: a collaborative meta-analysis of 102 prospective studies. Lancet. 2010;375:2215–2222. - PMC - PubMed
    1. Wolf PA, D'Agostino RB, Belanger AJ, et al. Probability of stroke: a risk profile from the Framingham Study. Stroke. 1991;22:312–318. - PubMed

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