Pre-stroke glycemia in patients with diabetes

Singh, Amrinder; Brooks, Desiree D.; Abrams, Taryn A.; Poorak, Mitra D.; Gunio, Drew; Kandhal, Prianka; Lakhanpal, Aleena; Sethuraman, Sankara; Bruno, Askiel

doi:10.1016/j.dsx.2017.07.011

Cited by 3 publications

(2 citation statements)

References 13 publications

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“…10 Diabetic control was poor in 45.3% of our IS patients with a higher median HbA1c (7.4%) than the 6.8% reported from a metropolitan Australian hospital. 25 However, data from other developed countries such as the United States (64%), 35 Italy (65.2%) 36 and Taiwan (63.5%) 37 have demonstrated a much higher prevalence of poorly controlled DM in stroke patients. This could be due to differences in medication adherence and cohort size between studies.…”

Section: Discussionmentioning

confidence: 99%

Diabetes in ischaemic stroke in a regional Australian hospital: uncharted territory

Low

O'Connor

et al. 2022

Internal Medicine Journal

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Background Stroke and diabetes mellitus (DM) are significant interrelated healthcare issues but there is a dearth of data on the prevalence of DM among Australia's regional stroke population. Aims We aimed to determine the prevalence of DM in stroke patients at a large regional centre, including subanalyses on stroke subtypes, glycaemic control and renal function in ischaemic stroke (IS). Methods We conducted a retrospective analysis of all patients (n = 323) with IS or transient ischaemic attack (TIA) admitted to Ballarat Base Hospital from January 2015 to December 2016. Demographic data, cardiovascular risk factors, aetiology/territory of IS, pre‐morbid DM status, indicators of glycaemic control and renal impairment were recorded. Results DM was present in 28.5% of IS and TIA patients, including 4% being newly diagnosed. Among diabetic IS patients, 45.3% had poor glycaemic control (HbA1c ≥7.0%) while 16% had moderate to severe renal impairment (estimated glomerular filtration rate of <30). The majority of IS were partial anterior circulation stroke (53.4%) and cardioembolism was the commonest mechanism (43.5%). We found no significant association between DM and a specific stroke location or mechanism. Conclusions Almost one‐third of IS/TIA patients had DM, with a significant proportion showing poor glycaemic control. The DM prevalence in our cohort was comparable with reported rates from other developed countries. Although we found no association between DM and a particular stroke type or mechanism, it is likely a reflection of our cohort size. Our study demonstrated that DM, as a significant risk factor in IS, warrants early detection and better management strategies.

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Section: Discussionmentioning

confidence: 99%

Diabetes in ischaemic stroke in a regional Australian hospital: uncharted territory

Low

O'Connor

et al. 2022

Internal Medicine Journal

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“…Stroke is the third leading cause of death in the world, seriously threatening human health and placing economic and medical burden on society and families [1]. Diabetes mellitus (DM) is a known risk factor for stroke, and hyperglycemia can cause various microvascular and macrovascular diseases [1,2]. However, the development of diagnostic criteria for diabetes is based on the risk of developing eye and kidney disease rather than cardiovascular disease [3].…”

Section: Introductionmentioning

confidence: 99%

Longitudinal Average Glucose Levels and Variance and Risk of Stroke: A Chinese Cohort Study

Peng

Wang³

et al. 2020

International Journal of Hypertension

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Background. Diabetes is a known independent risk factor for stroke. However, whether higher glucose levels (126–139.9 mg/dl) can increase the risk of stroke in people without diabetes is still unknown. Moreover, as a fluctuating parameter, long-term glucose levels may also be related to the risk of stroke outcome. It is important to explore the correlation between long-term average blood glucose, as well as its variability, and stroke. Methods. We used 40,975 clinical measurements of glucose levels and 367 measurements of glycated hemoglobin A1c levels from 12,321 participants without stroke to examine the relationship between glucose levels and the risk of stroke. Participants were from the Weitang Geriatric Diseases study, including 5,707 men and 6,614 women whose mean age at baseline was 60.8 years; 1,011 participants had diabetes, and 11,310 did not. We estimated the long-term average blood glucose level based on the multilevel Bayesian model and fit in Cox regression models, stratified according to diabetes status. Results. Over a median follow-up period of 5 years, stroke developed in 279 of the 12,321 participants (244 without diabetes and 35 with). For people with an average glucose level of 126–139.9 mg per deciliter, compared with 90–99.9 mg per deciliter, the adjusted hazard ratio (HR) for total stroke was 1.78 (95% confidence interval (CI), 1.16–2.75), and the HR for levels higher than 140 mg per deciliter was 1.89 (95% CI, 1.09–3.29). Among those without diabetes whose glucose level was higher than 140 mg per deciliter, compared with 90–99.9 mg per deciliter, the adjusted HRs for total stroke and fatal stroke were 3.66 (95% CI, 1.47–9.08) and 5 (95% CI, 1.77–14.15), respectively. For a glucose standard deviation level higher than 13.83 mg per deciliter, compared with that lower than 5.91 mg per deciliter, the adjusted HR for total stroke was 2.31 (95% CI, 1.19–4.48). Conclusions. Our results suggest that higher average glucose levels (126–139.9 mg/dl) and variance may be risk factors for stroke, even among people without diabetes diagnosis.

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Impaired Retinal Vasoreactivity as an Early Marker of Stroke Risk in Diabetes

Bettermann¹,

Sinha²

2019

Neuromethods

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Pre-stroke glycemia in patients with diabetes

Cited by 3 publications

References 13 publications

Diabetes in ischaemic stroke in a regional Australian hospital: uncharted territory

Diabetes in ischaemic stroke in a regional Australian hospital: uncharted territory

Longitudinal Average Glucose Levels and Variance and Risk of Stroke: A Chinese Cohort Study

Impaired Retinal Vasoreactivity as an Early Marker of Stroke Risk in Diabetes

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