Journal ArticleDOI
Diabetes, hyperglycaemia, and acute ischaemic stroke.
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TLDR
Uncertainty surrounds the question of whether glucose-lowering treatment for early stroke can improve clinical outcome, and achievement of normoglycaemia in the early stage of stroke can be difficult, and the possibility of hypglycaemia remains a concern.Abstract:
Diabetes and ischaemic stroke often arise together. People with diabetes have more than double the risk of ischaemic stroke after correction for other risk factors, relative to individuals without diabetes. Multifactorial treatment of risk factors for stroke-in particular, lifestyle factors, hypertension, and dyslipidaemia-will prevent a substantial number of these disabling strokes. Hyperglycaemia occurs in 30-40% of patients with acute ischaemic stroke, also in individuals without a known history of diabetes. Admission hyperglycaemia is associated with poor functional outcome, possibly through aggravation of ischaemic damage by disturbing recanalisation and increasing reperfusion injury. Uncertainty surrounds the question of whether glucose-lowering treatment for early stroke can improve clinical outcome. Achievement of normoglycaemia in the early stage of stroke can be difficult, and the possibility of hypoglycaemia remains a concern. Phase 3 studies of glucose-lowering therapy in acute ischaemic stroke are underway.read more
Citations
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Standards of Medical Care in Diabetes
TL;DR: These standards of care are intended to provide clinicians, patients, researchers, payors, and other interested individuals with the components of diabetes care, treatment goals, and tools to evaluate the quality of care.
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Intensive insulin therapy for the critically ill patients with stress hyperglycemia
TL;DR: Intensive insulin therapy and keeping blood glucose at 4.4 to 6.1 mmol/L can improve the clinical curative effect and reduce the mortality for the critically ill patients with stress hyperglycemia.
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Vascular contributions to cognitive impairment and dementia including Alzheimer's disease
Heather M. Snyder,Roderick A. Corriveau,Suzanne Craft,James E. Faber,Steven M. Greenberg,David S. Knopman,Bruce T. Lamb,Thomas J. Montine,Chris B. Schaffer,Julie A. Schneider,Cheryl L. Wellington,Donna M. Wilcock,Gregory J. Zipfel,Berislav V. Zlokovic,Lisa J. Bain,Francesca Bosetti,Zorina S. Galis,Walter J. Koroshetz,Maria C. Carrillo +18 more
TL;DR: A summary of the meeting and the resultant discussion of how vascular factors contribute to Alzheimer's disease and related dementia is summarized, including an outline of next steps needed to move this area of research forward.
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Dementia and cognitive decline in type 2 diabetes and prediabetic stages: towards targeted interventions
Geert Jan Biessels,Mark W. J. Strachan,Frank L.J. Visseren,L. Jaap Kappelle,Rachel A. Whitmer +4 more
TL;DR: Possible opportunities for intervention to improve cognitive outcomes in people with type 2 diabetes are identified, and how treatment can be tailored to individual risk profiles and comorbidities is suggested.
References
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Standards of Medical Care in Diabetes
TL;DR: These standards of care are intended to provide clinicians, patients, researchers, payors, and other interested individuals with the components of diabetes care, treatment goals, and tools to evaluate the quality of care.
Journal ArticleDOI
Intensive Insulin Therapy in Critically Ill Patients
Greet Van den Berghe,Pieter Wouters,Frank Weekers,Charles Verwaest,Frans Bruyninckx,Miet Schetz,Dirk Vlasselaers,Patrick Ferdinande,Peter Lauwers,Roger Bouillon +9 more
TL;DR: Intensive insulin therapy to maintain blood glucose at or below 110 mg per deciliter reduces morbidity and mortality among critically ill patients in the surgical intensive care unit.
Journal ArticleDOI
Effects of intensive glucose lowering in type 2 diabetes
Hertzel C. Gerstein,Michael Miller,Robert P. Byington,David C. Goff,J. Thomas Bigger,John B. Buse,William C. Cushman,Saul Genuth,Faramarz Ismail-Beigi,Faramarz Ismail-Beigi,Richard H. Grimm,Jeffrey L. Probstfield,Denise G. Simons-Morton,William T. Friedewald +13 more
TL;DR: In this paper, the authors investigated whether intensive therapy to target normal glycated hemoglobin levels would reduce cardiovascular events in patients with type 2 diabetes who had either established cardiovascular disease or additional cardiovascular risk factors.
Journal ArticleDOI
Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes.
Anushka Patel,Stephen MacMahon,John Chalmers,Bruce Neal,Laurent Billot,Mark Woodward,Mark Woodward,Michel Marre,Mark E. Cooper,Paul Glasziou,Paul Glasziou,Diederick E. Grobbee,Pavel Hamet,Stephen B. Harrap,Simon Heller,Lisheng Liu,Giuseppe Mancia,Carl Erik Mogensen,C. Y. Pan,Neil R Poulter,Anthony Rodgers,Bryan Williams,Severine Bompoint,Bastiaan E. de Galan,Bastiaan E. de Galan,Rohina Joshi,F. Travert +26 more
TL;DR: A strategy of intensive glucose control, involving gliclazide (modified release) and other drugs as required, that lowered the glycated hemoglobin value to 6.5% yielded a 10% relative reduction in the combined outcome of major macrovascular and microvascular events, primarily as a consequence of a 21%relative reduction in nephropathy.
Journal ArticleDOI
Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients
TL;DR: Aspirin (or another oral antiplatelet drug) is protective in most types of patient at increased risk of occlusive vascular events, including those with an acute myocardial infarction or ischaemic stroke, unstable or stable angina, previous myocardian infarctions, stroke or cerebral ischaemia, peripheral arterial disease, or atrial fibrillation.
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