Brain Lesions in Patients with Type 2 Diabetes Mellitus
The objective of research — to establish the causes and patterns of structural and functional changes in the brain of patients with type 2 diabetes with ischemic stroke in order to improve the diagnosis, evaluation of the course, prognosis of diabetic encephalopathy and to design therapeutic programs. Materials and Methods. The study included 557 people, among them 288 men and 269 women, with ischemic stroke, mean age 64.6 ± 10.3 years. Results. Brain lesions in type 2 diabetes are heterogeneous, have two different niduses, which subsequently potentiate each other: vascular cause that is based on chronic hypoxia on the background of «echeloned» stenosis of cerebral arteries and violations in neurovascular unit structures, as well as extravascular cause which is based on inflammatory process in brain tissue, characterized by macrophage-microglial activation, penetration of antigen-presenting cells through the blood-brain barrier and lesion of neuronal and glial cell pools. Conclusions. The most important factors associated with the development of stroke and diabetes mellitus type 2 are female gender, medical history of hypertension, coronary heart disease, atrial fibrillation, alcohol abuse. Major anamnestic risk factors associated with mortality in the acute phase of stroke are: myocardial infarction, atrial fibrillation, coronary heart disease, female gender, age 70–80 years, smoking. The most common subtype of ischemic stroke in patients with diabetes mellitus is a lacunar stroke. Type 2 diabetes mellitus is an independent risk factor for the reduction of intellectual functions.
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