Progress in research on the association between glucose metabolism disorders and intracranial and extracranial atherosclerotic stenosis - Scorecard - MDSpire
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Progress in research on the association between glucose metabolism disorders and intracranial and extracranial atherosclerotic stenosis
Clinical Scorecard: Advancements in Understanding the Link Between Glucose Metabolism Disorders and Atherosclerotic Stenosis in Intracranial and Extracranial Vessels
At a Glance
Category
Detail
Condition
Intracranial and Extracranial Atherosclerotic Stenosis
Key Mechanisms
Hyperglycemia, insulin resistance, accumulation of advanced glycation end products (AGEs), oxidative stress, NLRP3 inflammasome activation, phenotypic switching of vascular smooth muscle cells (VSMCs)
Target Population
Individuals with glucose metabolism disorders including diabetes mellitus, insulin resistance, and impaired glucose tolerance
Care Setting
Clinical settings focusing on stroke prevention and management
Key Highlights
HbA1c ≥ 6.5% correlates with anterior circulation ICAS (OR = 2.04, P < 0.05)
TyG index positively correlates with asymptomatic ECAS (OR = 1.85) and asymptomatic ICAS (OR = 1.34)
Individuals with impaired glucose tolerance maintaining non-diabetic status have a 23% lower stroke risk compared to those with newly diagnosed diabetes (HR = 0.77, 95%CI 0.64–0.94)
Guideline-Based Recommendations
Diagnosis
Utilize HbA1c and TyG index as clinical screening tools for assessing risk of ICAS and ECAS
Management
Focus on interventions for individuals with impaired glucose tolerance to reduce stroke risk
Monitoring & Follow-up
Regular monitoring of glucose metabolism parameters in at-risk populations
Risks
Increased risk of ischemic stroke associated with diabetes and insulin resistance
Patient & Prescribing Data
Individuals with glucose metabolism disorders, particularly those at risk for ischemic stroke
Interventions aimed at maintaining non-diabetic status may lower stroke risk
Clinical Best Practices
Differentiate between ICAS and ECAS in clinical assessments
Consider structural differences in arteries when evaluating glucose metabolism disorders
Address insulin resistance in normoglycemic individuals as a potential risk factor
Over two days, specialists across neurology, neurosurgery and related subspecialties came together to discuss advances in stroke care, epilepsy, movement disorders, neurodegenerative disease, neuro-oncology, brain and spine surgery, interventional pain management and emerging technologies.
