title: The diagnosis and management of cerebrovascular disease in diabetes.
abstract: Cerebrovascular disease is a leading cause of morbidity and mortality in diabetes. Compared with nondiabetic patients, diabetic patients have at least twice the risk for stroke, earlier onset of symptoms, and worse functional outcomes. Approximately 20 % of diabetic patients will die from stroke, making it one of the leading causes of death in this population. Effective strategies for primary and secondary prevention of stroke have been developed in research cohorts that included both diabetic and nondiabetic patients. Nevertheless, prevention in diabetes has some specific considerations. In this paper, we summarize evidence to guide the diagnosis and management of stroke in diabetic patients. We propose that diabetic stroke patients should have a robust risk assessment to target interventions, like other patients with cerebrovascular disease, but with special attention to glycemic control and lifestyle modification.
authors.affiliation: VA Connecticut Healthcare System, 950 Campbell Avenue, West Haven, CT 06519, USA. michael.phipps@yale.edu
authors.forename: Michael S
authors.initials: MS
authors.lastname: Phipps
authors.forename: Ania M
authors.initials: AM
authors.lastname: Jastreboff
authors.forename: Karen
authors.initials: K
authors.lastname: Furie
authors.forename: Walter N
authors.initials: WN
authors.lastname: Kernan
mesh_terms: D001786:Blood Glucose / Q000378:metabolism; D002561:Cerebrovascular Disorders / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy; D003925:Diabetic Angiopathies / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D006973:Hypertension / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D020299:Intracranial Hemorrhage, Hypertensive / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy; D002546:Ischemic Attack, Transient / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy; D008297:Male; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D012307:Risk Factors; D020521:Stroke / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D007004:Hypoglycemic Agents; D010975:Platelet Aggregation Inhibitors; C517652:hemoglobin A1c protein, human