INCIDENCE OF ACUTE ISCHEMIC STROKE AMONG TYPE 2 DIABETIC PATIENTS IN A TERTIARY CARE SETTING
Keywords:
Type 2 Diabetes Mellitus, Acute Ischemic Stroke, CT Brain.Abstract
Background of the Study: Numerous studies demonstrate marked variations in stroke incidence and relative risk in people with diabetes when compared to non-diabetics. Possible explanations for these variations may include contradictory and heterogeneous definitions of diabetes mellitus and the method for counting and describing stroke events.
Methodology: The retrospective study cross sectional in nature had been done at the Department of Medicine, Bahawal Victoria Hospital, Quaid-e-Azam Medical College Bahawalpur, Pakistan. Patients having HbA1c of more than 7.0%, or two random blood glucose measurements of ≥200mg/dl, or prior diabetes diagnosis, or taking anti-hyperglycemic therapy were labelled as type 2 diabetes mellitus. Sudden loss or weakness in the function of one or more limbs (monoplegia or hemiplegia) on clinical examination assessed radiologically by CT brain scan was labelled as acute ischemic Stroke.
Results: Majority (n=289, 73.9%) had poor diabetes control. Acute Ischemic Stroke was seen in 49 (12.5%) patients of type 2 DM, having a statistical association with increasing age (0.002) but not with patient gender (0.452), duration of diabetes (p-value 0.126) or diabetes control (p-value 0.333).
Conclusion: Acute ischemic Stroke was not uncommon in the present retrospective study, being seen in 12.5% of patients with type 2 diabetes mellitus and being statistically linked to increasing age but not with gender of patient, diabetes duration or diabetes control.
References
Saeedi P, Petersohn I, Salpea P, Malanda B, Karuranga S, Unwin N, et al; IDF Diabetes Atlas Committee. Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas, 9th edition. Diabetes Res Clin Pract. 2019;157:107843.
Kvitkina T, Narres M, Claessen H, Metzendorf MI, Richter B, Icks A. Incidence of Stroke in People With Diabetes Compared to Those Without Diabetes: A Systematic Review. Exp Clin Endocrinol Diabetes. 2023;131(9):476-490.
Mehmood K, Khalid S, Butt NI, Ashfaq F, Khan AA. Anton’s Syndrome in Occipital Lobe Infarction. Pak J Ophthalmol. 2021, 37(3):338-340.
GBD 2016 Stroke Collaborators. Global, regional, and national burden of stroke, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol. 2019;18(5):439-458.
Rücker V, Heuschmann PU, O'Flaherty M, Weingärtner M, Hess M, Sedlak C, Schwab S, Kolominsky-Rabas PL. Twenty-Year Time Trends in Long-Term Case-Fatality and Recurrence Rates After Ischemic Stroke Stratified by Etiology. Stroke. 2020 Sep;51(9):2778-2785.
Waris U, Butt NI, Shafqat T, Hameed S, Ghouri MSA, Anser A. Diagnostic Accuracy of NIHSS Score in Predicting in-Hospital Mortality in Patients of Ischemic Stroke taking Actual in-Hospital Mortality as Gold Standard. National Journal of Health Sciences. 2023;8(1):23-27.
Kvitkina T, Narres M, Claessen H, Metzendorf MI, Richter B, Icks A. Incidence of Stroke in People With Diabetes Compared to Those Without Diabetes: A Systematic Review. Exp Clin Endocrinol Diabetes. 2023 Sep;131(9):476-490.
Maida CD, Daidone M, Pacinella G, Norrito RL, Pinto A, Tuttolomondo A. Diabetes and Ischemic Stroke: An Old and New Relationship an Overview of the Close Interaction between These Diseases. Int J Mol Sci. 2022;23(4):2397.
Huang S, Liu L, Tang X, Xie S, Li X, Kang X, et al. Research progress on the role of hormones in ischemic stroke. Front Immunol. 2022;13:1062977.
You S, Chen H, Miao M, Du J, Che B, Xu T, Liu CF, Zhang Y, He J, Zhong X, Cao Y. Prognostic significance of plasma SDF-1 in acute ischemic stroke patients with diabetes mellitus: the CATIS trial. Cardiovascular Diabetology. 2023 Oct 10;22(1):274.
Nasim H, Butt NI, Ashfaq F, Anwar A, Aftab S, Muaaz M. Frequency of Modifiable Risk Factors in Ischemic Stroke Patients at a Tertiary Care Hospital in Lahore Pakistan. Pakistan Journal of Medical Research. 2023 Jul 24;62(2):53-8.
Bragg F, Li L, Yang L, Guo Y, Chen Y, Bian Z, et al; China Kadoorie Biobank (CKB) collaborative group. Risks and Population Burden of Cardiovascular Diseases Associated with Diabetes in China: A Prospective Study of 0.5 Million Adults. PLoS Med. 2016;13(7):e1002026.
Rahman MS, Adams J, Peng W, Sibbritt D. A longitudinal investigation of the determinants of stroke survivors' utilisation of a healthy lifestyle for stroke rehabilitation in Australia. Sci Rep. 2024 Nov 4;14(1):26625.
Pang C, Chen Y, Chen Y, Lin E, Pan X, Xu Y, Yu H, Zhang W, Deng B. What is the impact of acute endocrine and metabolic alterations on long-term ischemic stroke prognosis: a prospective study. BMC Geriatr. 2024 Oct 22;24(1):859.
Almubayyidh M, Alghamdi I, Parry-Jones AR, Jenkins D. Prehospital identification of intracerebral haemorrhage: a scoping review of early clinical features and portable devices. BMJ Open. 2024 Apr 19;14(4):e079316.
Mohammedi K, Pigeyre M, Bosch J, Yusuf S, Gerstein HC. Relationships between ankle blood pressure indices and major adverse cardiovascular events in people with and without type 2 diabetes. Cardiovasc Diabetol. 2024;23(1):325.
Liu J, Luo F, Guo Y, Li Y, Jiang C, Pi Z, Luo J, Long Z, Wen J, Huang Z, Zhu J. Association between serum glucose potassium ratio and mortality in critically ill patients with intracerebral hemorrhage. Sci Rep. 2024 Nov 9;14(1):27391.
Chowdhury A, Gorain B, Mitra Mazumder P. Recent advancements in drug delivery system of flavonoids with a special emphasis on the flavanone naringenin: exploring their application in wound healing and associated processes. Inflammopharmacology. 2024 Nov 22.
Butt NI, Ashfaq F, Aftab S, Mahmood K, Anwar A. Cortical venous thrombosis in a patient with rheumatic heart disease and metallic prosthetic valves on warfarin: A case report. Professional Med J 2022; 29(8):1439-1443.
Folsom AR, Rasmussen ML, Chambless LE, Howard G, Cooper LS, Schmidt MI, et al. Prospective associations of fasting insulin, body fat distribution, and diabetes with risk of ischemic Stroke. The Atherosclerosis Risk in Communities (ARIC) Study Investigators. Diabetes Care. 1999;22(7):1077-83.
Ahmed Z, Chaudhary F, Agrawal DK. Epidemiology, Pathophysiology, and Current Treatment Strategies in Stroke. Cardiol Cardiovasc Med. 2024;8(4):389-404.
Malla G, Long DL, Judd SE, Irvin MR, Kissela BM, Lackland DT,. Does the Association of Diabetes With Stroke Risk Differ by Age, Race, and Sex? Results From the Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study. Diabetes Care. 2019;42(10):1966-1972.
Yu YY, Lei D, He Q, Chen W. A cohort study on the relationship between education level and high-risk population of stroke. Ibrain. 2021 Sep 28;7(3):181-191.
Hurwitz M, Bonomo J, Spitz J, Sharma G. Intersectionality and Social Drivers of Health in Cardiovascular Care. Methodist Debakey Cardiovasc J. 2024 Nov 5;20(5):98-110.
Kamal FZ, Lefter R, Jaber H, Balmus IM, Ciobica A, Iordache AC. The Role of Potential Oxidative Biomarkers in the Prognosis of Acute Ischemic Stroke and the Exploration of Antioxidants as Possible Preventive and Treatment Options. Int J Mol Sci. 2023;24(7):6389.
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