Wong Steven Wm, McGrath Nicole N
Department of Medicine, Northland District Health Board, Whangarei Hospital, Maunu Road, Maunu, Whangarei 0110, New Zealand.
N Z Med J. 2016 Jun 10;129(1436):62-6.
To assess our prevalence and screening rate for diabetes and pre-diabetes in people presenting with acute stroke and transient ischaemic attack (TIA) in Northland, New Zealand, as well as identifying discrepancies between Māori and non-Māori, rates of atrial fibrillation (AF) and effect of metformin on stroke.
Data was collected retrospectively on people diagnosed with stroke or TIA in Northland, between 1 January 2014 and 31 December 2014.
345 people presented with acute stroke/TIA. 49.5% had dysglycaemia: 24.3% diabetes, 25.2% pre-diabetes. An HbA1c was performed on 70.4%. Māori had more diabetes (41.6%) than non-Māori (19.4%), with an HbA1c 12 mmol/mol (3.2%) higher, and were 12 years younger on average. There was no difference in AF prevalence between people with and without diabetes, and in the proportion of severe stroke (total anterior circulation infarction) between people with diabetes on metformin and those not.
The prevalence of dysglycaemia in acute stroke/TIA in Northland is high. The goal of universal HbA1c screening in stroke is not being met. Māori have stroke younger, and a higher prevalence of diabetes may partially explain this. No association between diabetes and AF was found, nor evidence that metformin may be protective against larger strokes.
评估新西兰北地地区急性中风和短暂性脑缺血发作（TIA）患者中糖尿病和糖尿病前期的患病率及筛查率，同时确定毛利人和非毛利人之间的差异、房颤（AF）发生率以及二甲双胍对中风的影响。
回顾性收集2014年1月1日至2014年12月31日期间在北地地区被诊断为中风或TIA的患者的数据。
345例患者出现急性中风/TIA。49.5%患有血糖异常：24.3%为糖尿病，25.2%为糖尿病前期。70.4%的患者进行了糖化血红蛋白（HbA1c）检测。毛利人患糖尿病的比例（41.6%）高于非毛利人（19.4%），HbA1c高12 mmol/mol（3.2%），且平均年龄小12岁。糖尿病患者和非糖尿病患者的房颤患病率无差异，服用二甲双胍的糖尿病患者和未服用二甲双胍的糖尿病患者中重度中风（完全前循环梗死）的比例也无差异。
北地地区急性中风/TIA患者中血糖异常的患病率较高。中风患者普遍进行HbA1c筛查的目标未实现。毛利人中风发病年龄较轻，较高的糖尿病患病率可能部分解释了这一现象。未发现糖尿病与房颤之间存在关联，也没有证据表明二甲双胍可能对较大面积中风具有保护作用。
