Table 1.
Cerebrovascular Complications of Diabetes: Key Findings
| Findings | References | |
|---|---|---|
| Clinical | ||
| Chronic | 2–6 x increased incidence | 5, 6, 13, 14 |
| Increased mortality | 12 | |
| Decreased event rate with glycemic control | 18, 20, 22 | |
| BP lowering decreases risk | 24 | |
| Statin therapy decreases risk | 25, 26 | |
| Acute | Increased mortality | 30 |
| Worsened outcome | 28, 29, 32, 33 | |
| Increased hemorrhage after reperfusion therapy | 34 – 38 | |
|
| ||
| Experimental | ||
| Chronic | ||
| Structure | Thick basement membrane | 48 – 53 |
| Swollen astrocytic endfeet | 50, 51 | |
| Degeneration of endothelium | 54 | |
| Increased remodeling | 51, 56, 57 | |
| Increased neovascularization | 57 | |
| Increased BBB permeability | 57, 64, 65 | |
| Increased MMP2/9 | 56, 57 | |
| Function | Decreased vasodilation | 50, 72 – 90 |
| Decreased myogenic tone | 59, 82, 91 | |
| Acute | Increased infarct size | 5, 56, 96 – 98, 100 – 103 |
| Increased edema | 5, 96 | |
| Increased reperfusion injury/hemorrhage | 5, 56, 96 | |
BP = Blood pressure; BBB = Blood brain barrier; MMP= Matrix metalloprotease