Abstract

Background: Diabetes mellitus the metabolic disorder can interact with atherosclerosis in ischemic strokes to initiate activate and propagate vascular events. To formulate effective preventive measures, it is mandatory to understand the impact of the glycemic status on the severity and functional outcome of Acute Ischemic stroke in patients with diabetes. Purpose of the study: Study the effect of Glycemic status at admission on severity and outcome of Acute Ischemic stroke in patients with diabetes. Materials and methods: The study is a prospective, case-control, hospital based study done at Department of Neurology, Narayana medical college for a period of 1½ year. Results: 130 acute ischemic stroke patients were studied. 100 patients were cases with diabetes mellitus. Remaining 30 patients were controls without diabetes. Case were subcategorised to good glycemic control (HbA1c 7) 97.5% patients of poor glycemic control group has moderate to severe stroke severity >7 (NIHSS) at admission and 53.3% of good glycemic control patients has mild severity (NIHSS=1-6). 95% of good glycemic control group and 96.7% of non-diabetic control group patients have functional independence at 3 months of follow up. 47.5% of Poor glycemic control patients have functional dependence at 3 months of follow up. Conclusion: Glycemic control has significant association on severity and outcome of ischemic stroke patients with diabetes. Estimation of HbA1c levels at the time of admission might be a predictor of the severity of neurological impairment and functional outcome in patients with acute ischemic stroke and diabetes mellitus.

Highlights

  • Stroke is the most common clinical manifestation of cerebrovascular disease which represents one of the clinical endpoint of atherosclerosis

  • Total number of patients analysed for the study: 130, cases were100 acute ischemic stroke patients with diabetes

  • Among the diabetic stroke patients the severity of deranged glycemic status found to have an influencing effect on the stroke severity and functional outcome

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Summary

Introduction

Stroke is the most common clinical manifestation of cerebrovascular disease which represents one of the clinical endpoint of atherosclerosis. It is the disease of the cerebral blood vessels nourishing the brain. In most of the ischemic strokes the underlying pathophysiology is atherosclerosis, which is a chronic inflammatory disorder in which immune mechanisms interact with modifiable metabolic risk factor like diabetes mellitus to initiate, activate and propagate vascular events. Diabetes mellitus the metabolic disorder can interact with atherosclerosis in ischemic strokes to initiate activate and propagate vascular events. Purpose of the study: Study the effect of Glycemic status at admission on severity and outcome of Acute Ischemic stroke in patients with diabetes To formulate effective preventive measures, it is mandatory to understand the impact of the glycemic status on the severity and functional outcome of Acute Ischemic stroke in patients with diabetes.

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