Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Re-defining future stroke risk among pre-diabetics

08.06.2012
Studies suggest greater danger, but risk appears to vary by definition

Millions of pre-diabetic Americans may be at increased risk of future stroke, say researchers at the University of California, San Diego School of Medicine in a new meta-analysis of epidemiological studies, but the precise degree of that threat is confounded by differing medical definitions and factors that remain unknown or unmeasured.

"The immediate implication of our findings is that people with pre-diabetes should be aware they are at increased risk of stroke, and that this condition is frequently associated with one or more major risk factors for cardiovascular disease," said Bruce Ovbiagele, MD, a professor of neurosciences at UC San Diego School of Medicine and the study's senior author. "Beyond that, there's a great need to further refine our understanding of that risk and how it's measured."

Writing in the June 8 online edition of the British Medical Journal, Ovbiagele and an international team of colleagues reviewed 15 qualifying prospective cohort studies that looked at the association between pre-diabetes and stroke risk. The studies, published between 2004 and 2011, involved 760,925 participants.

Pre-diabetes occurs when blood glucose levels are consistently higher than normal, but not yet high enough to be diagnosed as diabetes. The condition is widespread in the United States: An estimated 35 percent of American adults – approximately 79 million people – are believed to be pre-diabetic, and thus at greater risk of developing full-blown type-2 diabetes, which afflicts roughly 26 million Americans. Diabetes is the seventh leading cause of death in the U.S., and a major risk factor for heart disease and stroke, the first and fourth leading causes of death.

People with pre-diabetes typically have the same risk factors for cardiovascular disease as people with type 2 diabetes – specifically, high blood pressure, high cholesterol levels and obesity – but the condition's effect on future stroke risk has not been established.

Ovbiagele and colleagues found that an association between future stroke risk and pre-diabetes depended upon the definition of the latter. To determine whether someone has pre-diabetes, blood glucose levels are typically measured after a 12-hour fast. According to the 1997 American Diabetes Association (ADA), a normal fasting glucose measurement ranges between 70.2 to 100 milligrams per deciliter (mg/dL). A level between 100 and 126 mg/dL is considered pre-diabetic. A level of 126 mg/dL or above is diabetic.

By the 1997 standard, the researchers found that pre-diabetics in the studies with a fasting glucose measurement of 110 to 125 mg/dL carried a 21 percent higher chance of suffering a future stroke. Heart disease and stroke account for roughly two-thirds of all deaths among people with diabetes.

In 2003, however, the ADA redefined the fasting glucose level for pre-diabetes to 100 to 125 mg/dL. Using this less stringent definition, the researchers found no increased stroke risk for pre-diabetics. Indeed, when they analyzed three studies that provided information on participants with fasting glucose levels of 100 to 109 mg/dL they found no increased risk of stroke.

Ovbiagele said the difference in the findings suggests there may be a "threshold effect" in the relationship between fasting glucose levels and future stroke risk. "Elevated risk may only begin at or above a fasting glucose level of 110 mg/dL," he said.

Additional research is needed to determine the best definition predicting stroke risk among diabetics, Ovbiagele noted. It should include an assessment of more recent glycemic biomarkers, such as glycosylated hemoglobin, and be followed by randomized, controlled trials involving drugs and/or lifestyle modification to evaluate the effect of treatments on reducing the risk of future strokes.

"In the meantime, to avoid progression to diabetes or occurrence of strokes, clinicians should strongly consider recommending therapeutic lifestyle changes and maximizing the control of established stroke risk factors in their patients with pre-diabetes," Ovbiagele said.

Co-authors of the study are Meng Lee, Chang Gung University College of Medicine, Chiayi, Taiwan; Jeffrey L. Saver and Sarah Song, University of California, Los Angeles; Heun-Sik Hong, Inje University, South Korea and Kuo-Hsuan Chang, Chang Gung University College of Medicine, Linkuo, Taiwan.

Funding, in part, came from Chang Gung Memorial Hospital and the National Institutes of Health (grants P50 NS044378 and U01 NS079179).

Scott LaFee | EurekAlert!
Further information:
http://www.ucsd.edu

More articles from Health and Medicine:

nachricht New study points the way to therapy for rare cancer that targets the young
22.11.2017 | Rockefeller University

nachricht Penn study identifies new malaria parasites in wild bonobos
21.11.2017 | University of Pennsylvania School of Medicine

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Nanoparticles help with malaria diagnosis – new rapid test in development

The WHO reports an estimated 429,000 malaria deaths each year. The disease mostly affects tropical and subtropical regions and in particular the African continent. The Fraunhofer Institute for Silicate Research ISC teamed up with the Fraunhofer Institute for Molecular Biology and Applied Ecology IME and the Institute of Tropical Medicine at the University of Tübingen for a new test method to detect malaria parasites in blood. The idea of the research project “NanoFRET” is to develop a highly sensitive and reliable rapid diagnostic test so that patient treatment can begin as early as possible.

Malaria is caused by parasites transmitted by mosquito bite. The most dangerous form of malaria is malaria tropica. Left untreated, it is fatal in most cases....

Im Focus: A “cosmic snake” reveals the structure of remote galaxies

The formation of stars in distant galaxies is still largely unexplored. For the first time, astron-omers at the University of Geneva have now been able to closely observe a star system six billion light-years away. In doing so, they are confirming earlier simulations made by the University of Zurich. One special effect is made possible by the multiple reflections of images that run through the cosmos like a snake.

Today, astronomers have a pretty accurate idea of how stars were formed in the recent cosmic past. But do these laws also apply to older galaxies? For around a...

Im Focus: Visual intelligence is not the same as IQ

Just because someone is smart and well-motivated doesn't mean he or she can learn the visual skills needed to excel at tasks like matching fingerprints, interpreting medical X-rays, keeping track of aircraft on radar displays or forensic face matching.

That is the implication of a new study which shows for the first time that there is a broad range of differences in people's visual ability and that these...

Im Focus: Novel Nano-CT device creates high-resolution 3D-X-rays of tiny velvet worm legs

Computer Tomography (CT) is a standard procedure in hospitals, but so far, the technology has not been suitable for imaging extremely small objects. In PNAS, a team from the Technical University of Munich (TUM) describes a Nano-CT device that creates three-dimensional x-ray images at resolutions up to 100 nanometers. The first test application: Together with colleagues from the University of Kassel and Helmholtz-Zentrum Geesthacht the researchers analyzed the locomotory system of a velvet worm.

During a CT analysis, the object under investigation is x-rayed and a detector measures the respective amount of radiation absorbed from various angles....

Im Focus: Researchers Develop Data Bus for Quantum Computer

The quantum world is fragile; error correction codes are needed to protect the information stored in a quantum object from the deteriorating effects of noise. Quantum physicists in Innsbruck have developed a protocol to pass quantum information between differently encoded building blocks of a future quantum computer, such as processors and memories. Scientists may use this protocol in the future to build a data bus for quantum computers. The researchers have published their work in the journal Nature Communications.

Future quantum computers will be able to solve problems where conventional computers fail today. We are still far away from any large-scale implementation,...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Ecology Across Borders: International conference brings together 1,500 ecologists

15.11.2017 | Event News

Road into laboratory: Users discuss biaxial fatigue-testing for car and truck wheel

15.11.2017 | Event News

#Berlin5GWeek: The right network for Industry 4.0

30.10.2017 | Event News

 
Latest News

Corporate coworking as a driver of innovation

22.11.2017 | Business and Finance

PPPL scientists deliver new high-resolution diagnostic to national laser facility

22.11.2017 | Physics and Astronomy

Quantum optics allows us to abandon expensive lasers in spectroscopy

22.11.2017 | Physics and Astronomy

VideoLinks
B2B-VideoLinks
More VideoLinks >>>