Blood sugar if uncontrolled, may lead to ischemic stroke

Japan: Poor blood sugar control in diabetes may increase the risk for ischemic stroke in the posterior circulation, according to a recent study published in the journal Neurology.

Blood sugar or glycemic parameters if not controlled in diabetes can lead to complications pertaining to Cardiovascular system, Nervous system, kidney and eyes.

Junya Kuroda, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan, and colleagues conducted the study to determine whether diabetes or glucose metabolism is associated with ischemic stroke in the posterior circulation.

The researchers prospectively studied 10,245 patients with acute ischemic stroke (mean age 72.7 ± 12.5 years, men 59.5%) who were enrolled in a multicenter hospital-based stroke registry in Fukuoka, Japan, between June 2007 and August 2016. Posterior circulation ischemic stroke (PCIS) was defined as brain infarction in the territory of the posterior cerebral artery and vertebro-basilar arteries.

The associations between diabetes or glycemic parameters were investigated including Blood sugar concentrations, hemoglobin A1c, and the homeostatic model assessment of insulin resistance (HOMA-IR), and PCIS using logistic regression analysis.

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Key findings of the study include:

• Diabetes was significantly associated with PCIS even after adjusting for multiple confounding factors.


• Fasting (1.07 [1.02–1.12]/SD), casual plasma glucose (1.16 [1.11–1.20]/SD) concentrations, and hemoglobin A1c (1.12 [1.08–1.17]/SD), but not HOMA-IR (1.02 [0.97–1.07]/SD), were associated with PCIS.


• These associations were maintained in patients with ischemic stroke because of thrombotic etiology and were unchanged even after the propensity score matching methods.


• In patients with diabetes, the ORs of PCIS further increased with an increase in hemoglobin A1c and the presence of microvascular complications.


• A total of 38.5% of diabetics had a PCIS compared with 30.4% of nondiabetics.

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Poor glycemic control may be associated with an increased risk of thrombotic infarction that occurs preferentially in the posterior circulation of the brain.