Impaired glucose metabolism in patients with acute stroke and no previous diagnosis of diabetes mellitus

Vancheri, Federico; Curcio, M. Joan; Burgio, Antonio; Salvaggio, Susanna; Gruttadauria, G; Lunetta, M; Dovico, Rossana; Alletto, Maurizio

doi:10.1093/qjmed/hci134

Cited by 80 publications

(92 citation statements)

References 38 publications

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“…[18][19][20][21] We infer that the most important reason was a high prevalence and low awareness of DM in China. A recent national-wide study showed that the prevalence of DM among Chinese aged 60 to 69 years was 25%, 22 and the proportion of those knowing of their DM was only 40%.…”

Section: August 2016mentioning

confidence: 89%

“…[18][19][20][21] A European study had investigated the prevalence of NDDM using the newly proposed HbA1c criteria and indicated that the prevalence of NDDM was 25% in patients with stroke or transient ischemic attack. 20 In our study, 32% of the patients were diagnosed using the glucose-based criteria, ‡P value between DN (total) and non-DM.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Prognosis of Ischemic Stroke With Newly Diagnosed Diabetes Mellitus According to Hemoglobin A1c Criteria in Chinese Population

Jing

Pan

Zhao

et al. 2016

Stroke

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Background and Purpose-Hemoglobin A1c (HbA1c) was recommended to diagnose diabetes mellitus, but whether newly diagnosed diabetes mellitus (NDDM) according to the new criteria was associated with stroke prognosis was unclear. We aimed to investigate the prognosis of ischemic stroke with NDDM according to the new criteria. Methods-Ischemic stroke without a diabetes mellitus history in the survey on Abnormal Glucose Regulation in Patients With Acute Stroke Across China were included in the analysis. NDDM was defined as fasting plasma glucose ≥7.0 mmol/L, 2-hour oral glucose tolerance test ≥11.1 mmol/L, or HbA1c ≥6.5%, and NDDM was divided into group 1, diagnosed by glucose criteria (fasting plasma glucose ≥7.0 mmol/L or 2-hour oral glucose tolerance test ≥11.1 mmol/L with/without HbA1c ≥6.5%), or group 2, diagnosed by single high HbA1c (fasting plasma glucose <7.0 mmol/L, 2-hour oral glucose tolerance test <11.1 mmol/L, and HbA1c ≥6.5%). The association between NDDM and 1-year prognosis (mortality, stroke recurrence, and poor functional outcome [modified Rankin scale score 3-6]) was estimated. Results-Among 1251 ischemic stroke patients, 539 were NDDM and 141 of NDDM with single high HbA1c. NDDM was an independent risk factor for 1-year mortality (hazard ratio, 1.12; 95% confidence interval, 1.001-1.26), stroke recurrence (hazard ratio, 1.14; 95% confidence interval, 1.01-1.28), and poor functional outcome (odds ratio, 2.58; 95% confidence interval, 1.95-3.43) compared with non-diabetes mellitus. Nevertheless, NDDM with single high HbA1c was not significantly associated with 1-year prognosis for all end points (P>0.05 for all). Conclusions-NDDM by new criteria was associated with poor prognosis at 1 year after ischemic stroke; however, NDDM with single high HbA1c did not predict a poor prognosis.

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Section: August 2016mentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Prognosis of Ischemic Stroke With Newly Diagnosed Diabetes Mellitus According to Hemoglobin A1c Criteria in Chinese Population

Jing

Pan

Zhao

et al. 2016

Stroke

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“…Several studies from Europe and Japan in which OGTT was performed supplied either no diagnosis of IFG or small sample sizes. 13,24 Data on the prevalence of IFG and IGT among patients with intracerebral hemorrhage or SAH remained scarce. Our results indicate high prevalence of IGT and newly diagnosed DM in patients with intracerebral hemorrhage and SAH, which suggested that the identification of abnormal glucose regulation should be emphasized in the patients not only with ischemic stroke but also with intracerebral hemorrhage and SAH, and OGTT should be performed in all the stroke patients without history of diabetes after acute stage of stroke.…”

Section: Jia Et Al Abnormal Glucose After Stroke 653mentioning

confidence: 99%

Abnormal Glucose Regulation in Patients With Acute Stroke Across China

Jia

Zheng

Wang

et al. 2012

Stroke

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Background and Purpose— The prevalence of diabetes is high among patients with ischemic stroke. However, the prevalence of abnormal glucose regulation and clinical characteristics among patients with stroke in the Chinese population is uncertain. We investigated the prevalence of prediabetes and diabetes in Chinese patients after stroke onset in a nationwide cohort study and investigated abnormal glucose regulation in patients with acute stroke across China (ACROSS-China). Methods— The ACROSS-China study consecutively recruited patients hospitalized for acute stroke in 2008 to 2009 and investigated the prevalence of impaired glucose tolerance and diabetes among the patients on day 14 after stroke onset. Oral glucose tolerance test was performed in the diagnosis of abnormal glucose regulation. Results— The prevalence of abnormal glucose regulation was 68.7% among all the patients with stroke. Diabetes was identified in 42.3% of all the patients (45.8% for patients with ischemic stroke, 31.2% for patients with intracerebral hemorrhage, and 26.4% for patients with subarachnoid hemorrhage, respectively). Prediabetes (impaired fasting glucose and impaired glucose tolerance) was identified in 26.4% of all the patients with stroke. The prevalence of diabetes and impaired glucose tolerance was the highest in the patients with atherothrombotic infarction (73.4%). Conclusions— The prevalence of abnormal glucose regulation was high in Chinese patients with acute stroke, especially in patients with atherothrombotic infarction. Oral glucose tolerance test identified a large percentage of patients with newly diagnosed diabetes or impaired glucose tolerance after stroke onset.

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“…The reported prevalence of diabetes at discharge in a cohort of 106 people (median age 71 years) with acute ischaemic stroke and no history of diabetes was 46% based on an OGTT (Vancheri et al, 2005). At admission a further 29% already had a diagnosis of diabetes.…”

Section: Case Detection and Diagnosis June 2009mentioning

confidence: 99%

Testing for type 2 diabetes in Indigenous Australians: guideline recommendations and current practice

Paul

Ishiguchi

DʼEste

et al. 2017

Medical Journal of Australia

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Objectives: To determine the proportion of Aboriginal Controlled Community Health Service (ACCHS) patients tested according to three national diabetes testing guidelines; to investigate whether specific patient characteristics were associated with being tested. Design, setting and participants: Cross‐sectional study of 20 978 adult Indigenous Australians not diagnosed with diabetes attending 18 ACCHSs across Australia. De‐identified electronic whole service data for July 2010 – June 2013 were analysed. Main outcomes measures: Proportions of patients appropriately screened for diabetes according to three national guidelines for Indigenous Australians: National Health and Medical Research Council (at least once every 3 years for those aged 35 years or more); Royal Australian College of General Practitioners and Diabetes Australia (at least once every 3 years for those aged 18 years or more); National Aboriginal Community Controlled Health Organisation (annual testing of those aged 18 years or more at high risk of diabetes). Results: 74% (95% CI, 74–75%) of Indigenous adults and 77% (95% CI, 76–78%) of 10 760 patients aged 35 or more had been tested for diabetes at least once in the past 3 years. The proportions of patients tested varied between services (range: all adults, 16–90%; people aged 35 years or more, 23–92%). 18% (95% CI, 18–19%) of patients aged 18 or more were tested for diabetes annually (range, 0.1–43%). Patients were less likely to be tested if they were under 50 years of age, were transient rather than current patients of the ACCHS, or attended the service less frequently. Conclusions: Some services achieved high rates of 3‐yearly testing of Indigenous Australians for diabetes, but recommended rates of annual testing were rarely attained. ACCHSs may need assistance to achieve desirable levels of testing.

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Impaired glucose metabolism in patients with acute stroke and no previous diagnosis of diabetes mellitus

Cited by 80 publications

References 38 publications

Prognosis of Ischemic Stroke With Newly Diagnosed Diabetes Mellitus According to Hemoglobin A1c Criteria in Chinese Population

Prognosis of Ischemic Stroke With Newly Diagnosed Diabetes Mellitus According to Hemoglobin A1c Criteria in Chinese Population

Abnormal Glucose Regulation in Patients With Acute Stroke Across China

Testing for type 2 diabetes in Indigenous Australians: guideline recommendations and current practice

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