title: Cerebrovascular complications of diabetes: focus on stroke.
abstract: Cerebrovascular complications make diabetic patients 2-6 times more susceptible to a stroke event and this risk is magnified in younger individuals and in patients with hypertension and complications in other vascular beds. In addition, when patients with diabetes and hyperglycemia experience an acute ischemic stroke they are more likely to die or be severely disabled and less likely to benefit from the one FDA-approved therapy, intravenous tissue plasminogen activator. Experimental stroke models have revealed that chronic hyperglycemia leads to deficits in cerebrovascular structure and function that may explain some of the clinical observations. Increased edema, neovascularization and protease expression as well as altered vascular reactivity and tone may be involved and point to potential therapeutic targets. Further study is needed to fully understand this complex disease state and the breadth of its manifestation in the cerebrovasculature.
authors.affiliation: Program in Clinical and Experimental Therapeutics, University of Georgia College of Pharmacy, Augusta, GA 30912, USA.
authors.forename: Adviye
authors.initials: A
authors.lastname: Ergul
authors.forename: Aisha
authors.initials: A
authors.lastname: Kelly-Cobbs
authors.forename: Maha
authors.initials: M
authors.lastname: Abdalla
authors.forename: Susan C
authors.initials: SC
authors.lastname: Fagan
mesh_terms: D000818:Animals; D054022:Cerebrum / Q000098:blood supply; D003925:Diabetic Angiopathies / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D006943:Hyperglycemia / Q000150:complications / Q000188:drug therapy; D006949:Hyperlipidemias / Q000150:complications / Q000188:drug therapy; D006973:Hypertension / Q000150:complications / Q000188:drug therapy; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D008297:Male; D051379:Mice; D051381:Rats; D012306:Risk; D020521:Stroke / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology*; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents; D007004:Hypoglycemic Agents; D010959:Tissue Plasminogen Activator