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Related Concept Videos

Ischemic Stroke l: Introduction01:15

Ischemic Stroke l: Introduction

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Ischemic stroke is an acute cerebrovascular condition in which blood flow to a brain region is suddenly interrupted, leading to tissue infarction. Neurons depend on continuous oxygen and glucose supply, so even brief reductions in perfusion cause energy failure, ionic imbalance, and irreversible injury. Ischemic strokes are classified into thrombotic and embolic types based on their underlying mechanisms.Thrombotic MechanismsThrombotic stroke develops when a clot forms within a cerebral artery.
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Ischemic Stroke ll: Pathophysiology01:15

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An ischemic stroke occurs when a cerebral blood vessel becomes obstructed, most often by a thrombus or embolus, interrupting the delivery of oxygen and glucose to brain tissue. Because neurons rely on continuous aerobic metabolism, energy failure begins within minutes of reduced perfusion. The region receiving the least blood flow becomes the infarct core, an area of irreversible cellular death. Surrounding this core lies the penumbra, a zone of hypoperfused but still viable tissue that is...
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Ischemic Heart Disease: Overview01:17

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Ischemic heart disease occurs when the heart's blood supply dwindles, causing an ominous lack of oxygen and nutrients. This deficiency, stemming from reduced or obstructed blood flow, spells danger, leading to heart muscle damage and dysfunction.
Atherosclerosis, the primary malefactor, orchestrates this dangerous condition. It manifests as the accumulation of fatty deposits, akin to insidious plaques, within arterial walls. As time elapses, these plaques metamorphose, hardening and...
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Diabetic Retinopathy01:27

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DefinitionDiabetic retinopathy is a microvascular complication of diabetes affecting the retinal blood vessels.Risk FactorsDiabetic retinopathy is present in almost all individuals with type 1 diabetes and more than 60% of those with type 2 diabetes after two decades of disease.The risk increases with poor glycemic control, hypertension, dyslipidemia, smoking, pregnancy, and puberty.Although cataracts and glaucoma are also more frequent in people with diabetes, retinopathy remains the leading...
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Peripheral Artery Disease I: Introduction01:30

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Peripheral artery disease (PAD) predominantly results from atherosclerosis, which involves the accumulation of fatty deposits, or plaques, within the walls of arteries. This causes them to narrow and harden, significantly reducing blood flow. PAD predominantly affects the legs, particularly the arteries supplying the thighs and calves. In rare cases, it may involve other arteries, including those in the arms.Etiology of PAD:The principal cause of PAD is atherosclerosis, which results from fatty...
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Type I Diabetes II: Pathophysiology01:26

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Type 1 diabetes mellitus arises from an immune-mediated destruction of pancreatic β-cells, resulting in an absolute deficiency of insulin. This process develops in genetically susceptible individuals when autoimmunity, environmental exposures, and immunologic dysregulation converge to trigger a targeted attack on the insulin-producing cells of the pancreas. The β-cells are located within the islets of Langerhans and are essential for regulating blood glucose by facilitating cellular...
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Related Experiment Video

Updated: Apr 27, 2026

Simultaneous Photothrombosis and Fiber Photometry to Induce and Monitor Ischemic Stroke in Behaving Mice
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Ischemic stroke in prediabetic patients.

Jaume Roquer1, Ana Rodríguez-Campello, Elisa Cuadrado-Godia

  • 1Servei de Neurologia, IMIM-Hospital del Mar, Passeig Marítim 25-29, 08003, Barcelona, Spain, jroquer@hospitaldelmar.cat.

Journal of Neurology
|July 16, 2014
PubMed
Summary

First-ever ischemic stroke patients with prediabetes show intermediate vascular risk factors. Unlike diabetes mellitus patients, prediabetes does not independently worsen stroke outcomes, with prognosis similar to non-diabetic individuals.

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Area of Science:

  • Neurology
  • Endocrinology
  • Cardiovascular Medicine

Background:

  • Prediabetes is a growing public health concern, characterized by elevated blood glucose levels below the diagnostic threshold for diabetes mellitus.
  • The impact of prediabetes on the clinical characteristics and prognosis of patients experiencing their first-ever ischemic stroke (IS) remains incompletely understood.
  • Understanding these differences is crucial for risk stratification and management of IS patients.

Purpose of the Study:

  • To delineate the clinical and demographic profiles of first-ever IS patients with prediabetes.
  • To compare these characteristics against those of patients with diabetes mellitus (DM) and without diabetes (non-DM).
  • To evaluate the association between prediabetes, DM, and stroke outcomes, including early neurological deterioration and long-term prognosis.

Main Methods:

  • Retrospective analysis of a prospective cohort of first-ever acute IS patients.
  • Patients were categorized into three groups: non-DM (HbA1c <5.7%), prediabetes (HbA1c 5.7-6.4%), and DM (previous diagnosis or HbA1c ≥6.5%).
  • Demographic data, clinical characteristics, vascular risk factors, stroke subtypes (TOAST classification), and outcome measures (END, 3-month poor outcome, mortality, rtPA treatment success) were compared.

Main Results:

  • No significant demographic differences were observed across the groups.
  • Prediabetic patients exhibited higher rates of arterial hypertension and waist circumference compared to non-DM patients.
  • DM patients presented with more hypercholesterolemia, higher BMI, and greater prevalence of coronary artery disease than prediabetic patients. Significant differences in TOAST subtype distribution were noted (p < 0.0001).
  • Multivariate analysis revealed that DM, but not prediabetes, is an independent predictor of early neurological deterioration and poor 3-month outcome after adjusting for age and stroke severity.
  • No differences in rtPA treatment success rates were found between the groups.

Conclusions:

  • First-ever IS patients with prediabetes display an intermediate vascular risk factor profile between non-DM and DM individuals.
  • Prediabetes is not an independent risk factor for adverse stroke outcomes, unlike diabetes mellitus.
  • The prognosis for IS patients with prediabetes is comparable to that of non-DM patients, suggesting a distinct clinical trajectory from those with established diabetes.