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[Diabetes mellitus and intracranial stenosis]
I Mendes1, P Baptista, F Soares
1Servicio de Neurología, Hospital Garcia de Orta, Almada, Portugal.
Insights
Diabetes significantly increases the risk of cerebrovascular accidents (CVAs) due to more frequent intracranial stenosis. This finding highlights diabetes as an independent risk factor for cerebrovascular disease, necessitating further study of intracranial circulation in diabetic patients.
Area of Science:
- Neurology
- Vascular Medicine
- Diabetology
Background:
- Diabetes mellitus elevates cerebrovascular accident (CVA) risk 3-5 fold compared to non-diabetics.
- Pathophysiological mechanisms linking diabetes and CVAs remain under-investigated.
Purpose of the Study:
- To determine if intracranial arteriosclerosis, indicated by stenosis on Doppler studies, is more prevalent in diabetics.
- To assess if this association is independent of other vascular risk factors.
Main Methods:
- Retrospective analysis of ischemic CVA/TIA patients from a cerebrovascular disease registry.
- Assessment of intracranial stenosis using color-coded vertebral carotid eco-Doppler and transcranial Doppler.
- Comparison of intracranial findings between diabetic and non-diabetic groups, considering hypertension, hypercholesterolemia, and smoking.
Main Results:
- 384 patients (71 diabetic, 313 non-diabetic) were analyzed; groups were comparable in age and sex.
- Intracranial stenosis was 3.13 times more frequent in diabetics (95% CI = 1.69-5.79).
- This increased frequency of stenosis persisted independently of other vascular risk factors.
Conclusions:
- Diabetes mellitus is a significant, independent risk factor for intracranial blood vessel alterations and subsequent CVAs.
- Intracranial stenosis is highly prevalent in diabetic patients, suggesting potential benefits from targeted therapeutic interventions.
Introduction:
The risk of having a cerebrovascular accident (CVA) is approximately 3 to 5 times greater in the diabetic population than in non-diabetics. The physiopathological mechanisms of CVAs in patients with diabetes mellitus are not well-known, since few studies of this have been done.
Objectives:
To verify the hypothesis that intracranial arteriosclerosis, interpreted from findings of stenosis on intracranial Doppler studies, is greater in diabetics than in non-diabetics, independently of other vascular risk factors.
Patients And Methods:
Patients were selected from the Register of Cerebrovascular Diseases of the Neurology Department of the Hospital de Santa Maria as having had an ischemic cerebrovascular accident (CVA)/transient ischemic accident (TIA), assessed by a colour codified vertebral carotid eco-Doppler and transcranial Doppler. Intracranial changes in the diabetic and non-diabetic groups of patients were compared with relation to the presence of risks such as hypercolestrolaemia, arterial hypertension and smoking.
Results:
384 patients were included, 71 were diabetic and 313 non-diabetic. The two groups were comparable with regard to average age and sex. Intracranial stenosis was approximately 3.13 (95% CI = 1.69-5.79) times more frequent in the diabetic population than in non-diabetics. This difference persisted independently of the presence or absence of other vascular risk factors.
Conclusions:
Diabetes mellitus is an important independent risk factor of alterations in the intracranial blood vessels and therefore of CVA. The intracranial circulation should be studied in these patients in view of the great frequency of intracranial stenoses and possible future improvements with therapeutic intervention.