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A Mouse Model of Hemorrhagic Transformation Induced by Acute Hyperglycemia Combined with Transient Focal Ischemia
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Prevention and treatment of ischaemic and haemorrhagic stroke in people with diabetes mellitus: a focus on glucose
Simona Sacco1, Matteo Foschi2, Raffaele Ornello2
1Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy. simona.sacco@univaq.it.
Diabetologia
|April 16, 2024
Summary
Diabetes significantly increases stroke risk and worsens outcomes. Managing blood sugar, blood pressure, and using new medications can improve stroke recovery and cardiovascular health in diabetic patients.
Area of Science:
- Neurology
- Endocrinology
- Cardiology
Background:
- Diabetes mellitus is a major risk factor for ischemic and hemorrhagic stroke.
- Diabetes and hyperglycemia negatively impact stroke outcomes, increasing risks of complications and poor functional recovery.
- Cardiovascular complications are common in diabetic individuals, necessitating tailored prevention strategies.
Purpose of the Study:
- To review hyperacute stroke management in diabetic patients.
- To discuss cardiovascular disease (CVD) prevention strategies for individuals with diabetes.
- To inform clinicians on evidence-based treatments for stroke and CVD in this population.
Main Methods:
- Review of large studies and randomized controlled trials (RCTs) on stroke management and CVD prevention in diabetes.
- Analysis of the impact of hyperglycemia on acute stroke outcomes.
- Evaluation of the role of intensive glucose control and newer pharmacotherapies.
Main Results:
- Hyperglycemia in acute ischemic stroke correlates with higher risk of hemorrhagic transformation and worse functional outcomes.
- Intensive glucose control, alongside blood pressure, coagulation, and temperature management, benefits outcomes after hemorrhagic stroke.
- Newer agents like SGLT2 inhibitors and GLP-1 receptor agonists offer tailored treatment options, especially for those with heart failure and CKD.
Conclusions:
- Early intervention to manage severe hyperglycemia is crucial in acute ischemic stroke.
- Comprehensive care bundles are beneficial for hemorrhagic stroke outcomes.
- Personalized CVD prevention strategies, utilizing novel medications, are essential for diabetic patients with comorbidities.
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