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Poor glycemic control and posterior circulation ischemic stroke.

Junya Kuroda1, Ryu Matsuo1, Yuko Yamaguchi1

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Neurology. Clinical Practice
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Summary

Diabetes and poor glycemic control increase the risk of posterior circulation ischemic stroke (PCIS). Higher hemoglobin A1c levels and microvascular complications further elevate this risk in diabetic patients.

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Area of Science:

  • Neurology
  • Endocrinology
  • Public Health

Background:

  • Ischemic stroke in the posterior circulation (PCIS) poses a significant health burden.
  • The relationship between diabetes, glucose metabolism, and PCIS requires further elucidation.

Purpose of the Study:

  • To investigate the association between diabetes and glycemic parameters with PCIS.
  • To determine if poor glycemic control impacts the risk of PCIS.

Main Methods:

  • A cohort of 10,245 acute ischemic stroke patients from a Japanese registry (2007-2016) were analyzed.
  • Logistic regression and propensity score matching were used to assess associations between diabetes, plasma glucose, hemoglobin A1c, HOMA-IR, and PCIS.

Main Results:

  • Diabetes significantly correlated with PCIS (OR 1.37 [1.25-1.50]).
  • Elevated fasting glucose, casual glucose, and hemoglobin A1c levels were associated with increased PCIS risk.
  • These associations persisted even in thrombotic stroke cases and after propensity score adjustment.

Conclusions:

  • Poor glycemic control is linked to an elevated risk of thrombotic infarction in the posterior cerebral circulation.
  • Diabetes management and monitoring glycemic parameters are crucial for PCIS prevention.