Diabetes, hyperglycemia and the management of cerebrovascular disease

Haratz, Salo; Tanné, David

doi:10.1097/wco.0b013e3283418fed

Cited by 33 publications

(16 citation statements)

References 56 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Diabetes is a metabolic disorder contributing to both large and small vessel diseases (20), and we were not sure that the study populations were confined to idiopathic PD. Although vascular parkinsonism possibly relating to major vascular disorders was generally taken into account during the recruitment phase or through adjusted analyses, the exclusion of parkinsonism related to microvascular complications should probably be based also on imaging techniques (21), even when the diagnosis of PD is made by a neurologist or a specialist in movement disorders.…”

Section: Discussionmentioning

confidence: 99%

Diabetes and Risk of Parkinson’s Disease

et al. 2011

View full text Add to dashboard Cite

OBJECTIVEDiabetes has been associated with chronic neurodegeneration. We performed a systematic review and meta-analysis to assess the relationship between pre-existing diabetes and Parkinson’s disease (PD).RESEARCH DESIGN AND METHODSOriginal articles in English published up to 10 May 2011 were searched for in electronic databases (PubMed, Embase, and Scopus) and by reviewing references of eligible articles. Prospective cohort and case-control studies providing risk and precision estimates relating to pre-existing diabetes and PD were considered eligible.RESULTSNine studies/1,947 citations (cohort, N = 4; case-control, N = 5) fulfilled inclusion criteria for meta-analysis. In prospective studies, the onset of diabetes before onset of PD was found to be a risk factor for future PD (relative risk [RR] = 1.37 [95%CI 1.21–1.55]; P < 0.0001). This association was confirmed by secondary analyses based on estimates derived after the exclusion of participants who had vascular disease at baseline and/or who developed vascular disease during follow-up (RR = 1.34 [1.14–1.58]; P < 0.001) and by sensitivity analyses addressing the association with diabetes at baseline or during follow-up. However, the association found for case-control studies was not significant (odds ratio [OR] 0.75 [95%CI 0.50–1.11]; P = 0.835). Sensitivity analysis based on estimates adjusted for BMI confirmed the lack of a relationship between PD and diabetes (OR 0.56 [0.28–1.15]; P = 0.089).CONCLUSIONSAlthough data from cohort studies suggest that diabetes is a risk factor for PD, there is no conclusive evidence on this association. Further prospective studies focused on putative pathogenic pathways and taking a broad range of confounders into account is required to clarify this relationship.

show abstract

Section: Discussionmentioning

confidence: 99%

Diabetes and Risk of Parkinson’s Disease

et al. 2011

View full text Add to dashboard Cite

show abstract

“…Metabolic diseases such as diabetes mellitus, which is diagnosed in nearly 40% of stroke patients [69], severely impair adult neurogenesis [75][76][77], are associated with increased pro-inflammatory state [78], and exacerbate ischemic damage [79][80][81]. Testing the regenerative potential of stem cell-based stroke therapy under such comorbidities and using animals of both sexes in experimental research will significantly enhance our ability to design effective treatment paradigms for clinical application.…”

Section: Translation Of Pre-clinical Success To the Clinic-avoiding Fmentioning

confidence: 99%

Neural Stem Cell-Based Therapy for Ischemic Stroke

Kokaia

Darsalia

2011

Transl. Stroke Res.

View full text Add to dashboard Cite

Stem cell-based approaches for the treatment of stroke have been the subject of intensive research over the past decade. Based on accumulated experimental evidence, stem cell-based therapy is a very promising prospect for the development of a novel treatment to restore stroke-damaged brain and impaired neurological function. Studies performed on experimental animal models of stroke employed a variety of stem cell types from diverse sources and have demonstrated their ability to replace lost neurons and functionally integrate into the brain, modulate inflammation, and stimulate angiogenesis and neurogenesis from an endogenous stem cell pool, most likely through trophic actions. A few clinical trials in stroke patients using stem cell transplantation have been completed or are on-going but the results have not yet proven the effectiveness of the stem cell-based approaches. A joint effort of stroke researchers and clinicians is needed to further optimize treatment protocols using safe and reproducible stem cell sources tested in relevant animal models of stroke and showing substantial neurological recovery of stroke-impaired function.

show abstract

“…The risk of stroke is increased 2- to 6-fold in patients with T2D [6] with greater risk for stroke recurrence and higher mortality rate [6,7]. Finally, a pre-diabetic state with impaired glucose tolerance is often detected in stroke patients following hospital admission, and such patients generally exhibit a poor prognosis [8,9]. …”

Section: Introductionmentioning

confidence: 99%

Glucagon-like peptide-1 receptor activation reduces ischaemic brain damage following stroke in Type 2 diabetic rats

et al. 2012

View full text Add to dashboard Cite

Diabetes is a strong risk factor for premature and severe stroke. The GLP-1R (glucagon-like peptide-1 receptor) agonist Ex-4 (exendin-4) is a drug for the treatment of T2D (Type 2 diabetes) that may also have neuroprotective effects. The aim of the present study was to determine the efficacy of Ex-4 against stroke in diabetes by using a diabetic animal model, a drug administration paradigm and a dose that mimics a diabetic patient on Ex-4 therapy. Furthermore, we investigated inflammation and neurogenesis as potential cellular mechanisms underlying the Ex-4 efficacy. A total of seven 9-month-old Type 2 diabetic Goto–Kakizaki rats were treated peripherally for 4 weeks with Ex-4 at 0.1, 1 or 5 μg/kg of body weight before inducing stroke by transient middle cerebral artery occlusion and for 2–4 weeks thereafter. The severity of ischaemic damage was measured by evaluation of stroke volume and by stereological counting of neurons in the striatum and cortex. We also quantitatively evaluated stroke-induced inflammation, stem cell proliferation and neurogenesis. We show a profound anti-stroke efficacy of the clinical dose of Ex-4 in diabetic rats, an arrested microglia infiltration and an increase of stroke-induced neural stem cell proliferation and neuroblast formation, while stroke-induced neurogenesis was not affected by Ex-4. The results show a pronounced anti-stroke, neuroprotective and anti-inflammatory effect of peripheral and chronic Ex-4 treatment in middle-aged diabetic animals in a preclinical setting that has the potential to mimic the clinical treatment. Our results should provide strong impetus to further investigate GLP-1R agonists for their neuroprotective action in diabetes, and for their possible use as anti-stroke medication in non-diabetic conditions.

show abstract

Diabetes, hyperglycemia and the management of cerebrovascular disease

Cited by 33 publications

References 56 publications

Diabetes and Risk of Parkinson’s Disease

Diabetes and Risk of Parkinson’s Disease

Neural Stem Cell-Based Therapy for Ischemic Stroke

Glucagon-like peptide-1 receptor activation reduces ischaemic brain damage following stroke in Type 2 diabetic rats

Contact Info

Product

Resources

About