Hyperglycemia and ischemic stroke: clinical features in patients with type 2 diabetes mellitus
- Authors: Izhbuldina G.I1, Novikova L.B.2
-
Affiliations:
- City Clinical Hospital № 18
- Bashkir State Medical University
- Issue: Vol 26, No 4 (2019)
- Pages: 56-60
- Section: Articles
- URL: https://journals.eco-vector.com/2073-4034/article/view/297954
- DOI: https://doi.org/10.18565/pharmateca.2019.4.56-60
- ID: 297954
Cite item
Open Access
Access granted
Abstract
Background. Among patients with acute cerebral circulation disorders, the frequency of hyperglycemia reaches 60%. To date, however, there is no consensus on the role of increasing glucose levels in the development of stroke, whether it has a physiological or pathological nature. Objective. Evaluation of the effect of hyperglycemia in the onset of ischemic stroke (IS) on the course and short-term clinical prognosis of the disease in patients with type 2 diabetes mellitus (DM2). Methods. 186 patients with IS and DM2 (54 men, 132 women) were examined, the average age was 67.8±7.72 years. Study design: case series. The degree of neurological deficit (NIHSS) and functional impairment (modified Rankin scale - mRs), and the fasting glucose level were assessed. The survey was carried out in the acute period of stroke at admission to the hospital and on the 21st day from the onset of the disease. Results. Hyperglycemia was detected in 76.3% of patients. Patients with glycemia >10.0 mmol/L were found to have a higher degree of neurological deficit than patients with normoglycemia (17.9%). Hyperglycemia >7.8 mmol/L was accompanied by a higher frequency of mRs 4-5 (by 25.6%) and a decrease in the incidence of apparent positive dynamics (by 27.7%). Conclusion. In DM2 patients, the development of IS is characterized by high levels of glycemia. Hyperglycemia is associated with the severity and clinical outcome of the disease.
Keywords
Full Text
About the authors
G. I Izhbuldina
City Clinical Hospital № 18Ufa, Russia
Lilia B. Novikova
Bashkir State Medical University
Email: novicova@inbox.ru
MD, Professor, Head of the Department of Neurology and Neurosurgery ICPE Ufa, Russia
References
- Béjot Y., Bailly H., DurierJ., Giroud M. Epidemiology of stroke in Europe and trends for the 21st century. Presse Med. 2016;45(12):391-98. doi: 10.1016/j.lpm.2016.10.003.
- Суслина З.А, Гулевская Т.С., Максимова М.Ю., Моргунов В.А. Нарушения мозгового кровообращения: диагностика, лечение, профилактика. М., 2016. 536 с
- Суслина З.А., Пирадов М.А., Домашенко М.А. Инсульт: оценка проблемы (15 лет спустя). Журнал неврологии и психиатрии им. С.С. Корсакова. 2014;11:5-13
- Дедов И.И., Шестакова М.В. Сосудистые поражения головного мозга при сахарном диабете: решенные и нерешенные вопросы. Журнал неврологии и психиатрии им. С.С. Корсакова. 2015;8:79-82.
- Bruno A., Leibeskind D., Hao Q., Raychev R. Diabetes mellitus, acute hyperglycemia, and ischemic stroke. Cur. Treat. Opt. Neurol. 2010;12:492-503. doi: 10.1007/s11940-010-0093-6.
- Badiger Sh., Akkasaligar P.T., Narone U. Hyperglycemia and Stroke. Int. J. Stroke Res. 2013;1:1-6.
- Clark M.E., Payton J.E., Pittiglio L.I. Acute ischemic stroke and hyperglycemia. Critical Care Nursing Quarterly. 2014;37:182-87.
- Liang J., Liu W., Sun J., et al. Analysis of the risk factors for the short-term prognosis of acute ischemic stroke. Int J Clin Exp Med. 2015;8(11):21915-24. doi: 10.1186/s12944-015-0080-8.
- Антонова К.В., Танашян М.М., Романцова Т.И., Максимова М.Ю. Острые нарушения мозгового кровообращения: клиническое течение и прогноз у больных сахарным диабетом 2 типа. Ожирение и метаболизм. 2016;13(2):20-5. doi: 10.14341/OMET2016220-25.
- Yao M., Ni J., Zhou L., Peng B., Zhu Y.L. SMART investigators. Elevated Fasting Blood Glucose Is Predictive of Poor Outcome in Non-Diabetic Stroke Patients: A Sub-Group Analysis of SMART. PLoS One 2016;11(8):e0160674. Doi: 10.1371/ journal.pone.0160674.
- Дедов И.И., Шестакова М.В., Майоров А.Ю. и др. Алгоритмы специализированной медицинской помощи больным сахарным диабетом. Сахарный диабет. 2017;20(1):1-112. Doi: 10.14341/ DM20171S8.
- Наследов А.Д. SPSS 19: Профессиональный статистический анализ данных. СПб., 2011. 400 с.
- Танашян М.М., Лагода О.В., Антонова К.В., Раскуражев А.А. Основные патогенетические механизмы развития сосудистой патологии мозга при атеросклерозе и метаболическом синдроме: поиск путей коррекции. Анналы клинической и экспериментальной неврологии. 2016;10(2):5-10.
- Brannick B., Dagogo-J.S. Prediabetes and Cardiovascular Disease: Pathophysiology and Interventions for Prevention and Risk Reduction. Endocrinol Metab Clin North Am. 2018;47(1):33-doi: 10.1016/j.ecl.2017.10.001.
- Клыпа Т.В., Орехова М.С., Забросаева Л.И. Гипергликемия критических состояний. Сахарный диабет. 2015;18(1):33-41. doi: 10.14341/DM2015133-41
- Bilotta F., Rosa G. Glycemia management in critical care patients. World J. Diabetes. 2012;3(7):130-34. doi: 10.4239/wjd.v3.i7.130.
- Kansagara D., Fu R., Freeman M., Wolf F., Helfand M. Intensive insulin therapy in hospitalized patients: A systematic review. Ann Intern Med. 2011;154(4):268-82. doi: 10.7326/00034819-1544-201102150-00008.
- Сунцов Ю.И., Болотская Л.Л., Маслова О.В., Казаков И.В. Эпидемиология сахарного диабета и прогноз его распространенности в Российской Федерации. Сахарный диабет. 2011;14(1):15-19.
Supplementary files
