Koffijberg, Juliet (2020) Clinical phenotyping of patients with disturbed glucose metabolism after ischemic stroke or TIA. thesis, Medicine.
Full text available on request.Abstract
Introduction: Disturbed glucose metabolism is an increasing important target in secondary stroke prevention. Glucose disturbances can be detected by fasting plasma glucose, 2-hour postload glucose and HbA1c. Our aim was to determine the clinical phenotype of patients with ischemic stroke or TIA and disturbed glucose metabolism. We also assessed the difference in prevalence and clinical phenotype of patients with disturbed glucose metabolism per detection method and looked into disturbed glucose metabolism in young stroke patients. Methods: Patients with ischemic stroke or TIA were derived from the Erasmus Stroke Study. Fasting plasma glucose, 2-hour postload glucose and HbA1c were measured on the second to fourth day after the event. Disturbed glucose metabolism was defined according to the ADA-criteria. Results: 71.1% of patients with no history of diabetes had disturbed glucose metabolism. Patients with more vascular risk factors and more severe ischemic stroke more frequently had unrecognized disturbed glucose metabolism. Patients with elevated glucose measurements on all tests had the most cardiovascular risk factors. Young stroke patients with glucose disturbances had similar characteristics to older stroke patients. The majority of patients in the prediabetic range was detected by HbA1c, in the diabetic range by 2-hour postload glucose. 2-hour postload glucose detected more than 80% of women and young stroke patients with disturbed glucose metabolism. Discussion and conclusion: Disturbed glucose metabolism is highly prevalent in patients after stroke. The risk of disturbed glucose metabolism increases in patients with the number of vascular risk factors. 2-hour postload glucose seems to be paramount for diagnosing disturbed glucose metabolism in women and young stroke patients.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Dr. Den Hertog, H.M. and Dr. Zandbergen, A.A.M. and Dr. Kobben, J.J. |
| Faculty: | Medical Sciences |
| Date Deposited: | 19 Mar 2024 12:38 |
| Last Modified: | 19 Mar 2024 12:38 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3736 |
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