College of Medicine, I-Shou University, Kaohsiung, Taiwan.
Stroke Center and Department of Neurology, E-Da Hospital, Kaohsiung, Taiwan.
J Diabetes Investig. 2023 Jan;14(1):6-11. doi: 10.1111/jdi.13914. Epub 2022 Oct 1.
Stroke survivors suffer from various physical, emotional, and cognitive impairments. These changes are dynamic and depend on multiple factors, including underlying diseases, baseline brain function and pathology, the site of the stroke and the post-stroke inflammation, neurogenesis as well as the subsequent remodeling of the neuro-network. First we review the structural and pathological changes of the brain in stroke survivors with diabetes mellitus, which may lead to post-stroke cognitive dysfunction. Second, we provide evidence of hyperglycemia, diabetes mellitus, hypoglycemia, and their relationship with post-stroke cognitive impairment (PSCI) and post-stroke dementia (PSD). In addition to conventional biomarkers, such as HbA1c, we also provide other novel tools to predict PSCI/PSD, such as glycemic variability, receptor for advanced glycation end products, and gut microbiota. Finally, we attempt to provide some modifying methods for glycemic control, focusing on the prevention of PSCI/PSD.
中风幸存者会遭受各种身体、情绪和认知损伤。这些变化是动态的，取决于多种因素，包括潜在疾病、大脑的基础功能和病理学、中风部位以及中风后的炎症、神经发生以及随后的神经网络重塑。首先，我们回顾了糖尿病患者中风幸存者的大脑结构和病理学变化，这些变化可能导致中风后认知功能障碍。其次，我们提供了高血糖、糖尿病、低血糖及其与中风后认知障碍（PSCI）和中风后痴呆（PSD）的关系的证据。除了 HbA1c 等传统生物标志物外，我们还提供了其他预测 PSCI/PSD 的新工具，如血糖变异性、晚期糖基化终产物受体和肠道微生物群。最后，我们尝试提供一些血糖控制的调节方法，重点是预防 PSCI/PSD。
