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Diabetes mellitus and cerebral vascular disease
M Kameyama1, H Fushimi, F Udaka
1Department of Neurology, Sumitomo Hospital, Osaka, Japan.
Insights
Diabetes mellitus significantly increases the risk of cerebral infarction, particularly with high blood pressure and poor glucose control. This cerebrovascular disease involves more severe atherosclerosis in diabetic individuals.
Area of Science:
- Neurology
- Endocrinology
- Pathology
Background:
- Cerebrovascular disease, particularly cerebral infarction, is a known complication of diabetes mellitus.
- Diabetic patients exhibit more severe atherosclerosis in cervical and cerebral arteries compared to non-diabetics, especially affecting posterior circulation.
- Asymptomatic cerebral infarction is prevalent in diabetic individuals and can be detected using MRI.
Purpose of the Study:
- To investigate the incidence of vascular lesions and clinical history in diabetic autopsy subjects.
- To evaluate the long-term effects of blood pressure and glucose levels on cerebral infarction in stroke patients with and without diabetes mellitus.
Main Methods:
- Autopsy review of vascular lesions and clinical history in 51 diabetic subjects (25 male, 26 female).
- Long-term analysis of blood pressure and glucose values in 267 stroke patients (99 with diabetes) without cerebral embolism.
- Utilized Magnetic Resonance Imaging (MRI) for pathological and clinical evaluation of asymptomatic cerebral infarction.
Main Results:
- Diabetes mellitus is associated with non-fatal or small cerebral infarctions, often with multiple occurrences.
- Atherosclerosis in cervical and cerebral arteries is more severe in diabetics than non-diabetics.
- High blood pressure and poor glycemic control correlate with a higher incidence of cerebral infarction in diabetic patients.
Conclusions:
- Cerebral infarction is a significant cerebrovascular complication in diabetes mellitus.
- Effective management of hypertension and blood glucose is crucial for reducing cerebral infarction risk in diabetic patients.
- Early detection and evaluation of asymptomatic cerebral infarction using MRI are important in diabetic populations.
Abstract:
Non-fatal or small infarction, especially with multiple occurrence, is a feature of cerebrovascular disease complicating diabetes mellitus. The atherosclerosis of the cervical and cerebral arteries, especially in the posterior circulation, in diabetes is more severe than that in non-diabetics. We reviewed the incidence of vascular lesions, and clinical history in 25 male and 26 female diabetic autopsy subjects. In addition, the long-term effects of blood pressure and glucose values were evaluated in 267 stroke patients without cerebral embolism, 99 of whom had diabetes mellitus. Asymptomatic cerebral infarction is not rare in diabetic subjects, and can now be accurately pathologically and clinically evaluated using MRI. The results of our study indicate that high blood pressure and poor blood glucose control are associated with the higher incidence of cerebral infarction in the diabetic patients.