Study on the impact of long-term blood glucose fluctuations and blood glucose control on the occurrence of stroke in patients with type 2 diabetes mellitus
10.3969/j.issn.1006-6187.2024.02.004
- VernacularTitle:血糖波动及血糖控制在2型糖尿病患者发生脑卒中事件中作用的研究
- Author:
Zhihao HU
1
;
Shuai ZHU
;
Yuhua LI
;
Anle LI
;
Fang XIANG
;
Hongjie YU
;
Yiying ZHANG
Author Information
1. 201800 上海市嘉定区疾病预防控制中心慢性非传染性疾病防治科
- Keywords:
Stroke;
Blood glucose;
Fluctuation;
Control;
Diabetes mellitus,type 2
- From:
Chinese Journal of Diabetes
2024;32(2):101-107
- CountryChina
- Language:Chinese
-
Abstract:
Objective Explore the impact of long-term blood glucose fluctuations and blood glucose control on the stroke incidence in patients with type 2 diabetes mellitus(T2DM).Methods An observa-tional cohort of patients with T2DM was established based on"Shanghai Community Chronic Disease Health Management Service Objects"on October 1st,2018.Follow-ups were conducted every three months,and fasting blood glucose(FBG)were tested at each visit.Basic epidemiological data were collected via the Shanghai Community Health Management Information Platform or survey questionnaires,and stroke incidents were gathered via the"Shanghai Cardio-Cerebrovascular Event Monitoring System".The first reported stroke incident within the observation period was considered.The observational deadline was December 31st,2021.Standard deviation of FBG was used to evaluate blood glucose fluctuation and FBG control rate was used to reflect blood glucose control status.Cox Proportional Hazards Model was utilized to analyze the impacts.Results The cumulative observation time was 91,826.1 person-years for the study,in which there were 1785 cases of stroke events observed,implying a cumulative incidence of 5.73%and incidence rate of 1943.9/100000 person-years.The mean number of follow-ups(10.29±3.07)per patient was recorded.The details of the stroke cases were as follows:transient ischemic attacks(n=111,6.22%),non-lacunar brain infarctions(n=754,42.24%),lacunar brain infarctions(n=798,44.71%),intracerebral hemorrhages(n=80,4.48%),non-intracerebral hemorrhages(n=8,0.45%),subarachnoid hemorrhages(n=12,0.67%),and unclassified strokes(n=22,1.23%).After excluding subjects with less than five follow-ups,the Cox Proportional Hazards Model suggested that increased standard deviation of FBG was an independent risk factor for the first stroke incident,and an increased blood glucose control rate was an independent protective factor.Both the standard deviation of FBG and the blood glucose control rate were not correlated with stroke recurrence.Conclusion Long-term blood glucose fluctuations and blood glucose control can predict the risk of a first stroke in patients with T2DM.The relationship between blood glucose fluctuations,blood glucose management,and stroke recurrence requires further studies.
