Skip to main content
Erschienen in: InFo Neurologie + Psychiatrie 11/2020

24.11.2020 | Hypoglykämie | Zertifizierte Fortbildung Neurologie

Vaskuläre Risikofaktoren

Diabetes mellitus erhöht das Risiko für einen Schlaganfall

verfasst von: Prof. Dr. med. Hans-Christoph Diener, Prof. Dr. med. Martin Heni

Erschienen in: InFo Neurologie + Psychiatrie | Ausgabe 11/2020

Einloggen, um Zugang zu erhalten

Auszug

Der Diabetes mellitus ist ein wichtiger Risikofaktor für den Schlaganfall. Dabei spielen pathophysiologisch sowohl die durch den Diabetes bedingte Atherosklerose wie auch die Schädigung der kleinen penetrierenden Hirnarterien eine wichtige Rolle. Erhöhte Blutzuckerwerte verschlechtern beim akuten Schlaganfall die Prognose und reduzieren auch die Wirksamkeit von Thrombolyse und mechanischer Thrombektomie.
Literatur
1.
Zurück zum Zitat Heidenreich PA, Trogdon JG, Khavjou OA, Butler J, Dracup K, Ezekowitz MD, et al. Forecasting the future of cardiovascular disease in the United States: a policy statement from the American Heart Association. Circulation 2011;123(8):933-44 Heidenreich PA, Trogdon JG, Khavjou OA, Butler J, Dracup K, Ezekowitz MD, et al. Forecasting the future of cardiovascular disease in the United States: a policy statement from the American Heart Association. Circulation 2011;123(8):933-44
2.
Zurück zum Zitat American Diabetes Association. 10. Cardiovascular Disease and Risk Management: Standards of Medical Care in Diabetes-2020. Diabetes Care 2020;43(Suppl 1):111-S34 American Diabetes Association. 10. Cardiovascular Disease and Risk Management: Standards of Medical Care in Diabetes-2020. Diabetes Care 2020;43(Suppl 1):111-S34
3.
Zurück zum Zitat Chen R, Ovbiagele B, Feng W. Diabetes and Stroke: Epidemiology, Pathophysiology, Pharmaceuticals and Outcomes. Am J Med Sci 2016;351(4):380-6 Chen R, Ovbiagele B, Feng W. Diabetes and Stroke: Epidemiology, Pathophysiology, Pharmaceuticals and Outcomes. Am J Med Sci 2016;351(4):380-6
4.
Zurück zum Zitat Weir CJ, Murray GD, Dyker AG, Lees KR. Is hyperglycaemia an independent predictor of poor outcome after acute stroke? Results of a long-term follow up study. BMJ 1997;314(7090):1303-6 Weir CJ, Murray GD, Dyker AG, Lees KR. Is hyperglycaemia an independent predictor of poor outcome after acute stroke? Results of a long-term follow up study. BMJ 1997;314(7090):1303-6
5.
Zurück zum Zitat Bruno A, Levine SR, Frankel MR, Brott TG, Lin Y, Tilley BC, et al. Admission glucose level and clinical outcomes in the NINDS rt-PA Stroke Trial. Neurology 2002;59(5):669-74 Bruno A, Levine SR, Frankel MR, Brott TG, Lin Y, Tilley BC, et al. Admission glucose level and clinical outcomes in the NINDS rt-PA Stroke Trial. Neurology 2002;59(5):669-74
6.
Zurück zum Zitat Cao W, Ling Y, Wu F, Yang L, Cheng X, Dong Q. Higher Fasting Glucose Next Day after Intravenous Thrombolysis Is Independently Associated with Poor Outcome in Acute Ischemic Stroke. Journal of Stroke and Cerebrovascular Diseases 2015;24(1):100-3 Cao W, Ling Y, Wu F, Yang L, Cheng X, Dong Q. Higher Fasting Glucose Next Day after Intravenous Thrombolysis Is Independently Associated with Poor Outcome in Acute Ischemic Stroke. Journal of Stroke and Cerebrovascular Diseases 2015;24(1):100-3
7.
Zurück zum Zitat Goyal N, Tsivgoulis G, Pandhi A, Dillard K, Katsanos AH, Magoufis G, et al. Admission hyperglycemia and outcomes in large vessel occlusion strokes treated with mechanical thrombectomy. J Neurointerv Surg 2018;10(2):112-7 Goyal N, Tsivgoulis G, Pandhi A, Dillard K, Katsanos AH, Magoufis G, et al. Admission hyperglycemia and outcomes in large vessel occlusion strokes treated with mechanical thrombectomy. J Neurointerv Surg 2018;10(2):112-7
8.
Zurück zum Zitat Johnston KC, Bruno A, Pauls Q, Hall CE, Barrett KM, Barsan W et al. Intensive vs Standard Treatment of Hyperglycemia and Functional Outcome in Patients With Acute Ischemic Stroke: The SHINE Randomized Clinical Trial. JAMA 2019;322(4):326-35 Johnston KC, Bruno A, Pauls Q, Hall CE, Barrett KM, Barsan W et al. Intensive vs Standard Treatment of Hyperglycemia and Functional Outcome in Patients With Acute Ischemic Stroke: The SHINE Randomized Clinical Trial. JAMA 2019;322(4):326-35
9.
Zurück zum Zitat Powers WJ, Rabinstein AA, Ackerson T, Adeoye OM, Bambakidis NC, Becker K, et al. Guidelines for the Early Management of Patients With Acute Ischemic Stroke: 2019 Update to the 2018 Guidelines for the Early Management of Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke 2019;50(12): e344-e418 Powers WJ, Rabinstein AA, Ackerson T, Adeoye OM, Bambakidis NC, Becker K, et al. Guidelines for the Early Management of Patients With Acute Ischemic Stroke: 2019 Update to the 2018 Guidelines for the Early Management of Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke 2019;50(12): e344-e418
10.
Zurück zum Zitat American Diabetes Association. 15. Diabetes Care in the Hospital: Standards of Medical Care in Diabetes-2020. Diabetes Care 2020;43(Suppl 1):193-202 American Diabetes Association. 15. Diabetes Care in the Hospital: Standards of Medical Care in Diabetes-2020. Diabetes Care 2020;43(Suppl 1):193-202
11.
Zurück zum Zitat UK Prospective Diabetes Study (UKPDS) Group. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). UK Prospective Diabetes Study (UKPDS) Group. Lancet 1998;352(9131):837-53 UK Prospective Diabetes Study (UKPDS) Group. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). UK Prospective Diabetes Study (UKPDS) Group. Lancet 1998;352(9131):837-53
12.
Zurück zum Zitat Stratton IM, Adler AI, Neil HAW, Matthews DR, Manley SE, Cull CA, et al. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BJM 2000;321:405-12 Stratton IM, Adler AI, Neil HAW, Matthews DR, Manley SE, Cull CA, et al. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BJM 2000;321:405-12
13.
Zurück zum Zitat Riddle MC. Effects of intensive glucose lowering in the management of patients with type 2 diabetes mellitus in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial. Circulation 2010;122(8):844-6 Riddle MC. Effects of intensive glucose lowering in the management of patients with type 2 diabetes mellitus in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial. Circulation 2010;122(8):844-6
14.
Zurück zum Zitat Advance Collaborative Group, Patel A, MacMahon S, Chalmers J, Neal B, Billot L, et al. Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes. N Engl J Med 2008;358(24):2560-72 Advance Collaborative Group, Patel A, MacMahon S, Chalmers J, Neal B, Billot L, et al. Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes. N Engl J Med 2008;358(24):2560-72
15.
Zurück zum Zitat Ray KK, Seshasai SR, Wijesuriya S, Sivakumaran R, Nethercott S, Preiss D et al. Effect of intensive control of glucose on cardiovascular outcomes and death in patients with diabetes mellitus: a meta-analysis of randomised cont-rolled trials. Lancet 2009;373(9677):1765-72 Ray KK, Seshasai SR, Wijesuriya S, Sivakumaran R, Nethercott S, Preiss D et al. Effect of intensive control of glucose on cardiovascular outcomes and death in patients with diabetes mellitus: a meta-analysis of randomised cont-rolled trials. Lancet 2009;373(9677):1765-72
16.
Zurück zum Zitat Das SR, Everett BM, Birtcher KK, Brown JM, Januzzi JL, Jr., Kalyani RR et al. 2020 Expert Consensus Decision Pathway on Novel Therapies for Cardiovascular Risk Reduction in Patients With Type 2 Diabetes: A Report of the American College of Cardiology Solution Set Oversight Committee. J Am Coll Cardiol 2020;76(9):1117-45 Das SR, Everett BM, Birtcher KK, Brown JM, Januzzi JL, Jr., Kalyani RR et al. 2020 Expert Consensus Decision Pathway on Novel Therapies for Cardiovascular Risk Reduction in Patients With Type 2 Diabetes: A Report of the American College of Cardiology Solution Set Oversight Committee. J Am Coll Cardiol 2020;76(9):1117-45
17.
Zurück zum Zitat Vallon V, Thomson SC. Targeting renal glucose reabsorption to treat hyperglycaemia: the pleiotropic effects of SGLT2 inhibition. Diabetologia 2017;60(2):215-25 Vallon V, Thomson SC. Targeting renal glucose reabsorption to treat hyperglycaemia: the pleiotropic effects of SGLT2 inhibition. Diabetologia 2017;60(2):215-25
18.
Zurück zum Zitat Zinman B, Inzucchi SE, Lachin JM, Wanner C, Fitchett D, Kohler S, et al. Empagliflozin and Cerebrovascular Events in Patients With Type 2 Diabetes Mellitus at High Cardiovascular Risk. Stroke 2017;48(5):1218-25 Zinman B, Inzucchi SE, Lachin JM, Wanner C, Fitchett D, Kohler S, et al. Empagliflozin and Cerebrovascular Events in Patients With Type 2 Diabetes Mellitus at High Cardiovascular Risk. Stroke 2017;48(5):1218-25
19.
Zurück zum Zitat Wiviott SD, Raz I, Bonaca MP, Mosenzon O, Kato ET, Cahn A, et al. Dapagliflozin and Cardiovascular Outcomes in Type 2 Diabetes. N Engl J Med 2019;380(4):347-57 Wiviott SD, Raz I, Bonaca MP, Mosenzon O, Kato ET, Cahn A, et al. Dapagliflozin and Cardiovascular Outcomes in Type 2 Diabetes. N Engl J Med 2019;380(4):347-57
20.
Zurück zum Zitat Packer M, Anker SD, Butler J, Filippatos G, Pocock SJ, Carson P et al. Cardiovascular and Renal Outcomes with Empagliflozin in Heart Failure. N Engl J Med 2020;8;383(15):1413-24 Packer M, Anker SD, Butler J, Filippatos G, Pocock SJ, Carson P et al. Cardiovascular and Renal Outcomes with Empagliflozin in Heart Failure. N Engl J Med 2020;8;383(15):1413-24
21.
Zurück zum Zitat Zinman B, Wanner C, Lachin JM, Fitchett D, Bluhmki E, Hantel S, et al. Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes. N Engl J Med 2015;373(22):2117-28 Zinman B, Wanner C, Lachin JM, Fitchett D, Bluhmki E, Hantel S, et al. Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes. N Engl J Med 2015;373(22):2117-28
22.
Zurück zum Zitat Neal B, Perkovic V, Mahaffey KW, de Zeeuw D, Fulcher G, Erondu N, et al. Canagliflozin and Cardiovascular and Renal Events in Type 2 Diabetes. N Engl J Med 2017;377(7):644-57 Neal B, Perkovic V, Mahaffey KW, de Zeeuw D, Fulcher G, Erondu N, et al. Canagliflozin and Cardiovascular and Renal Events in Type 2 Diabetes. N Engl J Med 2017;377(7):644-57
23.
Zurück zum Zitat Perkovic V, Jardine MJ, Neal B, Bompoint S, Heerspink HJL, Charytan DM, et al. Canagliflozin and Renal Outcomes in Type 2 Diabetes and Nephropathy. N Engl J Med 2019;380(24):2295-306 Perkovic V, Jardine MJ, Neal B, Bompoint S, Heerspink HJL, Charytan DM, et al. Canagliflozin and Renal Outcomes in Type 2 Diabetes and Nephropathy. N Engl J Med 2019;380(24):2295-306
24.
Zurück zum Zitat McMurray JJV, Solomon SD, Inzucchi SE, Kober L, Kosiborod MN, Martinez FA, et al. Dapagliflozin in Patients with Heart Failure and Reduced Ejection Fraction. N Engl J Med 2019;381(21):1995-2008 McMurray JJV, Solomon SD, Inzucchi SE, Kober L, Kosiborod MN, Martinez FA, et al. Dapagliflozin in Patients with Heart Failure and Reduced Ejection Fraction. N Engl J Med 2019;381(21):1995-2008
25.
Zurück zum Zitat Trujillo JM, Nuffer W, Ellis SL. GLP-1 receptor agonists: a review of head-to-head clinical studies. Ther Adv Endocrinol Metab 2015;6(1):19-28 Trujillo JM, Nuffer W, Ellis SL. GLP-1 receptor agonists: a review of head-to-head clinical studies. Ther Adv Endocrinol Metab 2015;6(1):19-28
26.
Zurück zum Zitat Holman RR, Bethel MA, Mentz RJ, Thompson VP, Lokhnygina Y, Buse JB, et al. Effects of Once-Weekly Exenatide on Cardiovascular Outcomes in Type 2 Diabetes. N Engl J Med 2017;377(13):1228-39 Holman RR, Bethel MA, Mentz RJ, Thompson VP, Lokhnygina Y, Buse JB, et al. Effects of Once-Weekly Exenatide on Cardiovascular Outcomes in Type 2 Diabetes. N Engl J Med 2017;377(13):1228-39
27.
Zurück zum Zitat Marso SP, Daniels GH, Brown-Frandsen K, Kristensen P, Mann JF, Nauck MA, et al. Liraglutide and Cardiovascular Outcomes in Type 2 Diabetes. N Engl J Med 2016;375(4):311-22 Marso SP, Daniels GH, Brown-Frandsen K, Kristensen P, Mann JF, Nauck MA, et al. Liraglutide and Cardiovascular Outcomes in Type 2 Diabetes. N Engl J Med 2016;375(4):311-22
28.
Zurück zum Zitat Marso SP, Bain SC, Consoli A, Eliaschewitz FG, Jodar E, Leiter LA, et al. Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes. N Engl J Med 2016;375(19):1834-44 Marso SP, Bain SC, Consoli A, Eliaschewitz FG, Jodar E, Leiter LA, et al. Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes. N Engl J Med 2016;375(19):1834-44
29.
Zurück zum Zitat Husain M, Birkenfeld AL, Donsmark M, Dungan K, Eliaschewitz FG, Franco DR, et al. Oral Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes. N Engl J Med 2019;381(9):841-51 Husain M, Birkenfeld AL, Donsmark M, Dungan K, Eliaschewitz FG, Franco DR, et al. Oral Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes. N Engl J Med 2019;381(9):841-51
30.
Zurück zum Zitat Gerstein HC, Colhoun HM, Dagenais GR, Diaz R, Lakshmanan M, Pais P, et al. Dulaglutide and cardiovascular outcomes in type 2 diabetes (REWIND): a double-blind, randomised placebo-controlled trial. Lancet 2019;394(10193):121-30 Gerstein HC, Colhoun HM, Dagenais GR, Diaz R, Lakshmanan M, Pais P, et al. Dulaglutide and cardiovascular outcomes in type 2 diabetes (REWIND): a double-blind, randomised placebo-controlled trial. Lancet 2019;394(10193):121-30
31.
Zurück zum Zitat Pfeffer MA, Claggett B, Diaz R, Dickstein K, Gerstein HC, Kober LV, et al. Lixisenatide in Patients with Type 2 Diabetes and Acute Coronary Syndrome. N Engl J Med 2015;373(23):2247-57 Pfeffer MA, Claggett B, Diaz R, Dickstein K, Gerstein HC, Kober LV, et al. Lixisenatide in Patients with Type 2 Diabetes and Acute Coronary Syndrome. N Engl J Med 2015;373(23):2247-57
32.
Zurück zum Zitat Marsico F, Paolillo S, Gargiulo P, Bruzzese D, Dell'Aversana S, Esposito I, et al. Effects of glucagon-like peptide-1 receptor agonists on major cardiovascular events in patients with Type 2 diabetes mellitus with or without established cardiovascular disease: a meta-analysis of randomized controlled trials. Eur Heart J 2020;41(35):3346-58 Marsico F, Paolillo S, Gargiulo P, Bruzzese D, Dell'Aversana S, Esposito I, et al. Effects of glucagon-like peptide-1 receptor agonists on major cardiovascular events in patients with Type 2 diabetes mellitus with or without established cardiovascular disease: a meta-analysis of randomized controlled trials. Eur Heart J 2020;41(35):3346-58
33.
Zurück zum Zitat Heart Outcomes Prevention Evaluation (HOPE) Study Investigators. Effects of ramipril on cardiovascular and microvasular outcomes in people with diabetes mellitus: results of the HOPE study and MICRO-HOPE substudy. Lancet 2000;355:253-9 Heart Outcomes Prevention Evaluation (HOPE) Study Investigators. Effects of ramipril on cardiovascular and microvasular outcomes in people with diabetes mellitus: results of the HOPE study and MICRO-HOPE substudy. Lancet 2000;355:253-9
34.
Zurück zum Zitat Group AS, Cushman WC, Evans GW, Byington RP, Goff DC, Jr., Grimm RH, Jr., et al. Effects of intensive blood-pressure control in type 2 diabetes mellitus. N Engl J Med 2010;362(17):1575-85 Group AS, Cushman WC, Evans GW, Byington RP, Goff DC, Jr., Grimm RH, Jr., et al. Effects of intensive blood-pressure control in type 2 diabetes mellitus. N Engl J Med 2010;362(17):1575-85
35.
Zurück zum Zitat Patel A, MacMahon S, Chalmers J, Neal B, Woodward M, Billot L, et al. Effects of a fixed combination of perindopril and indapamide on macrovascular and microvascular outcomes in patients with type 2 diabetes mellitus (the ADVANCE trial): a randomised controlled trial. Lancet 2007;370(9590):829-40 Patel A, MacMahon S, Chalmers J, Neal B, Woodward M, Billot L, et al. Effects of a fixed combination of perindopril and indapamide on macrovascular and microvascular outcomes in patients with type 2 diabetes mellitus (the ADVANCE trial): a randomised controlled trial. Lancet 2007;370(9590):829-40
36.
Zurück zum Zitat Cholesterol Treatment Trialists' (CTT) Collaborators. Efficacy of cholesterol-lowering therapy in 18 686 people with diabetes in 14 randomised trials of statins: a meta-analysis. Lancet 2008;371:117-25 Cholesterol Treatment Trialists' (CTT) Collaborators. Efficacy of cholesterol-lowering therapy in 18 686 people with diabetes in 14 randomised trials of statins: a meta-analysis. Lancet 2008;371:117-25
37.
Zurück zum Zitat Cholesterol Treatment Trialists Collaboration. Efficacy and safety of statin therapy in older people: a meta-analysis of individual participant data from 28 randomised controlled trials. Lancet 2019;393(10170):407-15 Cholesterol Treatment Trialists Collaboration. Efficacy and safety of statin therapy in older people: a meta-analysis of individual participant data from 28 randomised controlled trials. Lancet 2019;393(10170):407-15
38.
Zurück zum Zitat Gaede P, Vedel P, Larsen N, Jensen GV, Parving HH, Pedersen O. Multifactorial intervention and cardiovascular disease in patients with type 2 diabetes. N Engl J Med 2003;348(5):383-33 Gaede P, Vedel P, Larsen N, Jensen GV, Parving HH, Pedersen O. Multifactorial intervention and cardiovascular disease in patients with type 2 diabetes. N Engl J Med 2003;348(5):383-33
39.
Zurück zum Zitat American Diabetes Society. Addendum. 10. Cardiovascular Disease and Risk Management: Standards of Medical Care in Diabetes-2020. Diabetes Care 2020;43(Suppl. 1):111-134 Diabetes Care 2020;43(8):1977-8 American Diabetes Society. Addendum. 10. Cardiovascular Disease and Risk Management: Standards of Medical Care in Diabetes-2020. Diabetes Care 2020;43(Suppl. 1):111-134 Diabetes Care 2020;43(8):1977-8
40.
Zurück zum Zitat Landgraf R, Aberle J, Birkenfeld AL, Gallwitz B, Kellerer M, Klein H, et al. Therapy of Type 2 Diabetes. Exp Clin Endocrinol Diabetes 2019;127(S 01):73-92 Landgraf R, Aberle J, Birkenfeld AL, Gallwitz B, Kellerer M, Klein H, et al. Therapy of Type 2 Diabetes. Exp Clin Endocrinol Diabetes 2019;127(S 01):73-92
41.
Zurück zum Zitat American Diabetes Association. 6. Glycemic Targets: Standards of Medical Care in Diabetes-2020. Diabetes Care 2020;43(Suppl 1):66-76 American Diabetes Association. 6. Glycemic Targets: Standards of Medical Care in Diabetes-2020. Diabetes Care 2020;43(Suppl 1):66-76
42.
Zurück zum Zitat Arbeláez-Quintero I, Palacios M. To Use or Not to Use Metformin in Cerebral Ischemia: A Review of the Application of Metformin in Stroke Rodents. Stroke Res Treat 2017;2017:9756429. Arbeláez-Quintero I, Palacios M. To Use or Not to Use Metformin in Cerebral Ischemia: A Review of the Application of Metformin in Stroke Rodents. Stroke Res Treat 2017;2017:9756429.
43.
Zurück zum Zitat Smith L, Chakraborty D, Bhattacharya P, Sarmah D, Koch S, Dave KR. Exposure to hypoglycemia and risk of stroke. Ann N Y Acad Sci 2018;1431(1):25-34 Smith L, Chakraborty D, Bhattacharya P, Sarmah D, Koch S, Dave KR. Exposure to hypoglycemia and risk of stroke. Ann N Y Acad Sci 2018;1431(1):25-34
44.
Zurück zum Zitat International Hypoglycaemia Study Group. . Hypoglycaemia, cardiovascular disease, and mortality in diabetes: epidemiology, pathogenesis, and management. Lancet Diabetes Endocrinol 2019;7(5):385-96 International Hypoglycaemia Study Group. . Hypoglycaemia, cardiovascular disease, and mortality in diabetes: epidemiology, pathogenesis, and management. Lancet Diabetes Endocrinol 2019;7(5):385-96
Metadaten
Titel
Vaskuläre Risikofaktoren
Diabetes mellitus erhöht das Risiko für einen Schlaganfall
verfasst von
Prof. Dr. med. Hans-Christoph Diener
Prof. Dr. med. Martin Heni
Publikationsdatum
24.11.2020
Verlag
Springer Medizin
Erschienen in
InFo Neurologie + Psychiatrie / Ausgabe 11/2020
Print ISSN: 1437-062X
Elektronische ISSN: 2195-5166
DOI
https://doi.org/10.1007/s15005-020-1517-9

Weitere Artikel der Ausgabe 11/2020

InFo Neurologie + Psychiatrie 11/2020 Zur Ausgabe

Zertifizierte Fortbildung Psychiatrie

CME: Diagnostik und Therapie bipolarer Störungen