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Hyperglycemia in stroke

Ling Wang, Zhiming Zhou, Xiguang Tian, Huaiming Wang, Dong Yang, Yonggang Hao, Zhonghua Shi, Min Lin, Zhen Wang, Dequan Zheng, Mingyi Tu, Wenjie Zi, Gelin Xu, Xinfeng Liu
BACKGROUND AND PURPOSE: The impacts of stress hyperglycemia and hypoglycemia on mortality of acute ischemic stroke patients treated with mechanical thrombectomy (MT) are largely unclear. This study aimed to use stress hyperglycemia ratio (SHR) to evaluate the influence of pretreatment relative blood glucose changes on mortality risk after MT. METHODS: The study retrospectively enrolled 321 acute ischemic stroke patients treated with MT. SHR was calculated as random blood glucose at admission divided by average blood glucose which estimated by glycosylated hemoglobin (HbA1c)...
January 2019: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Alina Mihaela Leustean, Manuela Ciocoiu, Anca Sava, Claudia Florida Costea, Mariana Floria, Claudia Cristina Tarniceriu, Daniela Maria Tanase
The prevalence of diabetes is steadily rising, and once it occurs, it can cause multiple complications with a negative impact on the whole organism. Complications of diabetes may be macrovascular: such as stroke and ischemic heart disease as well as peripheral vascular and microvascular diseases-retinopathy, nephropathy, and neuropathy. Key factors that cause cardiovascular disease in people with diabetes include hyperglycemia, dyslipidemia, obesity, insulin resistance, inflammation, hypertension, autonomic dysfunction, and decreased vascular response capacity...
2018: Journal of Diabetes Research
Maarja Andaloussi Mäe, Tian Li, Giacomo Bertuzzi, Elisabeth Raschperger, Michael Vanlandewijck, Liqun He, Khayrun Nahar, Annika Dalheim, Jennifer J Hofmann, Bàrbara Laviña, Annika Keller, Christer Betsholtz, Guillem Genové
Diabetes mellitus is associated with cognitive impairment and various central nervous system pathologies such as stroke, vascular dementia, or Alzheimer's disease. The exact pathophysiology of these conditions is poorly understood. Recent reports suggest that hyperglycemia causes cerebral microcirculation pathology and blood-brain barrier (BBB) dysfunction and leakage. The majority of these reports, however, are based on methods including in vitro BBB modeling or streptozotocin-induced diabetes in rodents, opening questions regarding the translation of the in vitro findings to the in vivo situation, and possible direct effects of streptozotocin on the brain vasculature...
November 29, 2018: Scientific Reports
Celestino Sardu, Michelangela Barbieri, Maria Luisa Balestrieri, Mario Siniscalchi, Pasquale Paolisso, Paolo Calabrò, Fabio Minicucci, Giuseppe Signoriello, Michele Portoghese, Pasquale Mone, Davide D'Andrea, Felice Gragnano, Alessandro Bellis, Ciro Mauro, Giuseppe Paolisso, Maria Rosaria Rizzo, Raffaele Marfella
OBJECTIVES: We evaluate whether the thrombus aspiration (TA) before primary percutaneous coronary intervention (PPCI) may improve STEMI outcomes in hyperglycemic patients. BACKGROUND: The management of hyperglycemic patients during STEMI is unclear. METHODS: We undertook an observational cohort study of 3166 first STEMI. Patients were grouped on the basis of whether they received TA or not. Moreover, among these patients we selected a subgroup of STEMI patients with hyperglycemia during the event (glycaemia > 140 mg/dl)...
November 29, 2018: Cardiovascular Diabetology
R K Talukder, M J Uddin, M Battacharjee, H Akhter, H Pandit, P Pandit, M A Rouf, M S Islam, A M Khan, R N Chowdhury, S U Ahammed, M B Hossain, K M Rahman, A B Kamrul-Hasan, M M Faysal, G Saha, M M Khan
Stroke is leading cause of death world wide, after coronary artery disease and cancer. A high proportion of patients suffering from an acute stress such as stroke or myocardial infarction may develop hyperglycemia, even in the absence of a preexisting diagnosis of diabetes. An observational comparative study was carried out at the Department of Neurology and Medicine, Mymensingh Medical College, Mymensingh, Bangladesh from July 2011 to June 2013 among purposively selected ninety-three patients with a view to assess the outcome of stress hyperglycemia on acute stroke...
October 2018: Mymensingh Medical Journal: MMJ
Chandler A Long, Zachary B Fang, Frances Y Hu, Shipra Arya, Luke P Brewster, Elizabeth Duggan, Yazan Duwayri
OBJECTIVE: Hyperglycemia is a common occurrence in patients undergoing cardiovascular surgery. It has been identified in several surgical cohorts that improved perioperative glycemic control reduced postoperative morbidity and mortality. A significant portion of the population with peripheral arterial disease suffers from the sequelae of diabetes or metabolic syndrome. A paucity of data exists regarding the relationship between perioperative glycemic control and postoperative outcomes in vascular surgery patients...
November 17, 2018: Journal of Vascular Surgery
Shuang Yao, Hao Li, Kaixiang Liu, Guangpeng Leng, Jian Yu
OBJECTIVE: To construct a prediction model for the risk of ischemic stroke (IS) by classification tree model, and evaluate its application value. METHODS: By cluster sampling, 858 IS patients with perfect clinical data from January to December 2017 in the Affiliated Hospital of Guilin Medical College (IS group) were enrolled, and 844 health checkups matched with the gender and age of IS patients in the same period were enrolled as controls (healthy control group)...
October 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Jiqing Qiu, Yu Cui, Lichao Sun, Yunbao Guo, Zhanpeng Zhu
RATIONALE: Chorea is a movement disorder characterized by randomly appearing involuntary movements of the face, neck, limbs, or trunk. Hemichorea is unilateral, involving one side of the body. Hemichorea is commonly caused by non-ketotic hyperglycemia and/or cerebrovascular injury to the contralateral basal ganglia. PATIENT CONCERNS: Here, we report the case of a patient diagnosed with hemichorea who had diabetes, cavernous angioma, and a small intracranial errhysis...
October 2018: Medicine (Baltimore)
Chrysi Koliaki, Stavros Liatis, Alexander Kokkinos
A wealth of clinical and epidemiological evidence has linked obesity to a broad spectrum of cardiovascular diseases (CVD) including coronary heart disease, heart failure, hypertension, stroke, atrial fibrillation and sudden cardiac death. Obesity can increase CVD morbidity and mortality directly and indirectly. Direct effects are mediated by obesity-induced structural and functional adaptations of the cardiovascular system to accommodate excess body weight, as well as by adipokine effects on inflammation and vascular homeostasis...
November 3, 2018: Metabolism: Clinical and Experimental
Angélique Arcambal, Janice Taïlé, Philippe Rondeau, Wildriss Viranaïcken, Olivier Meilhac, Marie-Paule Gonthier
Type 2 diabetes is associated with major vascular dysfunctions, leading to clinical complications such as stroke. It is also known that hyperglycemia dysregulates blood-brain barrier homeostasis by altering cerebral endothelial cell function. Oxidative stress may play a critical role. The aim of this study was to evaluate the effect of hyperglycemia and insulin on the production of redox, inflammatory and vasoactive markers by cerebral endothelial cells. Murine bEnd.3 cerebral endothelial cells were exposed to hyperglycemia in the presence or not of insulin...
October 23, 2018: Free Radical Biology & Medicine
V V Klimontov
A growing body of evidences indicates the role of increased glucose variability (GV) as an independent cardiovascular risk factor in diabetes. It has been shown that high GV is associated with coronary and carotid atherosclerosis in diabetic subjects. The impact of enhanced glycemic fluctuations on vascular wall is mediated through non-enzymatic glycation, oxidative stress, activation of inflammatory pathways, and endothelial dysfunction. Thus, the effects of high GV exacerbate the influence of chronic hyperglycemia...
October 2018: Kardiologiia
Syed Raza Shah, Najla Issa Najim, Zainab Abbasi, Mazia Fatima, Ayesha Altaf Jangda, Waqas Shahnawaz, Maira Shahid, Syed Arbab Shah
Canagliflozin is a new novel oral antidiabetic agent belonging to the class of sodium-glucose co-transporter 2 (SGLT2) inhibitors, inhibiting glucose reabsorption in the proximal tubule, leading to increased urinary glucose excretion and subsequently to reduction in plasma glucose concentration, in individuals with hyperglycemia. Before the approval of canagliflozin by the Food and Drug Administration (FDA) in 2013, a pair-wise meta-analyses of trials involving canagliflozin did not differ from control in terms of all-cause mortality, cardiovascular death, myocardial infarction, and stroke...
2018: Journal of Community Hospital Internal Medicine Perspectives
Joon-Tae Kim, David S Liebeskind, Reza Jahan, Bijoy K Menon, Mayank Goyal, Raul G Nogueira, Vitor M Pereira, Jan Gralla, Jeffrey L Saver
Background and Purpose- Understanding the influence of hyperglycemia on outcomes in terms of the pretreatment collateral status might contribute to the achievement of case-specific glucose management in acute ischemic stroke. We sought to investigate whether the glucose level can influence the pretreatment collateral status and functional outcomes of endovascular thrombectomy in acute ischemic stroke and whether the impact of hyperglycemia on outcomes can be modified by the pretreatment collateral status. Methods- We analyzed the Triple-S database, which includes individual patient data pooled from 3 prospective Solitaire stent retriever studies (SWIFT [Solitaire With the Intention for Thrombectomy], SWIFT PRIME [SWIFT as Primary Endovascular Treatment], and STAR [Solitaire Flow Restoration Thrombectomy for Acute Revascularization])...
November 2018: Stroke; a Journal of Cerebral Circulation
Paolo Bazzigaluppi, Evelyn M Lake, Tina L Beckett, Margaret M Koletar, Iliya Weisspapir, Stefan Heinen, James Mester, Aaron Lai, Rafal Janik, Adrienne Dorr, JoAnne McLaurin, Greg J Stanisz, Peter L Carlen, Bojana Stefanovic
Background and Purpose- Recent evidence suggests great potential of metabolically targeted interventions for treating neurological disorders. We investigated the use of the endogenous ketone body β-hydroxybutyrate (BHB) as an alternate metabolic substrate for the brain in the acute phase of ischemia because postischemic hyperglycemia and brain glucose metabolism elevation compromise functional recovery. Methods- We delivered BHB (or vehicle) 1 hour after ischemic insult induced by cortical microinjection of endothelin-1 in sensorimotor cortex of rats...
September 2018: Stroke; a Journal of Cerebral Circulation
Lu Liu, Xin Huang, Jinliao Gao, Yusong Guo, Yanqi Di, Shasha Sun, Xinli Deng, Jian Cao
Metabolic syndrome (MS) is a combination of symptoms characterized by central obesity, hypertension, hyperglycemia, and hyperlipidemia, which together increase the risk of heart disease, stroke and diabetes. In our study, we hypothesized that an EET-agonist (AUDA) would increase expression of PGC 1α and improve mitochondrial and endothelial functions, resulting in improved heart function in a rat model of MS. To investigate this, rats were randomly divided into four groups: 1) Control; 2) MS + ABCT; 3) MS + AUDA; and 4) MS + AUDA + SnMP...
October 2018: Journal of Pharmacological Sciences
Jun Mo, Lei Huang, Jianhua Peng, Umut Ocak, Jianmin Zhang, John H Zhang
Autonomic disturbances often occur in patients with acute cerebrovascular disease due to damage of the central autonomic network. We summarize the structures of the central autonomic network and the clinical tests used to evaluate the functions of the autonomic nervous system. We review the clinical and experimental findings as well as management strategies of post-stroke autonomic disturbances including electrocardiographic changes, cardiac arrhythmias, myocardial damage, thermoregulatory dysfunction, gastrointestinal dysfunction, urinary incontinence, sexual disorders, and hyperglycemia...
October 11, 2018: Neuroscience Bulletin
Ming Li Yee, Rosemary Wong, Mineesh Datta, Timothy Nicholas Fazlo, Mina Mohammad Ebrahim, Elissa Claire Mcnamara, Gerard De Jong, Christopher Gilfillan
Mitochondrial diseases are rare, heterogeneous conditions affecting organs dependent on high aerobic metabolism. Presenting symptoms and signs vary depending on the mutation and mutant protein load. Diabetes mellitus is the most common endocrinopathy, and recognition of these patients is important due to its impact on management and screening of family members. In particular, glycemic management differs in these patients: the use of metformin is avoided because of the risk of lactic acidosis. We describe a patient who presented with gradual weight loss and an acute presentation of hyperglycemia complicated by the superior mesenteric artery syndrome...
September 25, 2018: Endocrinology, Diabetes & Metabolism Case Reports
Cynthia Rajani, Wei Jia
Diabetes is a widespread, rapidly increasing metabolic disease that is driven by hyperglycemia. Early glycemic control is of primary importance to avoid vascular complications including development of retinal disorders leading to blindness, end-stage renal disease, and accelerated atherosclerosis with a higher risk of myocardial infarction, stroke and limb amputations. Even after hyperglycemia has been brought under control, "metabolic memory," a cluster of irreversible metabolic changes that allow diabetes to progress, may persist depending on the duration of hyperglycemia...
October 10, 2018: Frontiers of Medicine
Lin Yang, Tsun Kit Chu, Jinxiao Lian, Cheuk Wai Lo, Pak Ki Lau, Hairong Nan, Jun Liang
In this study we conducted a cross sectional study to comprehensively evaluated the risk factors of chronic kidney disease (CKD) in a large sample of Chinese adults under primary care for type 2 diabetes mellitus (T2DM). We investigated the risk factors associated with the prevalence of CKD in adults with T2DM, who were enrolled in the Risk Factor Assessment and Management Programme for Patients with Diabetes Mellitus (RAMP-DM) of Hong Kong from July 2014 to June 2017. We collected the individual data of 31,574 subjects, with mean age of 63...
October 2, 2018: Scientific Reports
Devin W McBride, Eric C K Gren, Wayne Kelln, William K Hayes, John H Zhang
Hemorrhagic transformation after ischemic stroke is an independent predictor for poor outcome and is characterized by blood vessel rupture leading to brain edema. To date, no therapies for preventing hemorrhagic transformation exist. Disintegrins from the venom of Crotalus atrox have targets within the coagulation cascade, including receptors on platelets. We hypothesized that disintegrins from C. atrox venom can attenuate hemorrhagic transformation by preventing activation of matrix metalloproteinase after middle cerebral artery occlusion (MCAO) in hyperglycemic rats...
September 22, 2018: Journal of Neuroscience Research
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