Stroke Revisited: Diabetes in Stroke

✍ Scribed by Seung-Hoon Lee (editor), Dong-Wan Kang (editor)

• Publisher: Springer
• Year: 2021
• Tongue: English
• Leaves: 234
• Category: Library

✦ Synopsis

This book presents state of the art knowledge on diabetes in stroke, covering both basic and clinical aspects in detail. The focus is in particular on two major areas: general knowledge of diabetes and diabetes from a stroke neurologist’s perspective. Readers will find up-to-date information on glucose metabolism, the pathophysiology of diabetes, the clinical significance of diabetes in stroke, the differential influence of diabetes on stroke mechanisms, principles of diabetes care, advances in treatment options, and clinical practice in the real world. The individual components of pathophysiology, management, and key issues are fully addressed with the aid of complementary illustrations that facilitate understanding of practical aspects and enable the reader to retrieve fundamental information quickly. The book is timely in bringing together within one volume the most important current knowledge on diabetes in stroke. It will be invaluable for stroke physicians, epidemiologists, and students seeking to acquire up-to-date knowledge.

✦ Table of Contents

Preface
Preface
Contents
Contributors
Part I: Basic Science: Diabetes and Stroke
1: Glucose Metabolism
1.1 Pancreatic β-Cell Function
1.1.1 Pancreas
1.1.2 Insulin
1.1.2.1 Synthesis
1.1.2.2 Secretion
1.1.2.3 Regulation of β-Cell Function
1.1.3 Glucagon and Other Counterregulatory Hormones
1.2 Normal Glucose Metabolism
1.2.1 Homeostasis (at the Level of an Organism)
1.2.1.1 Glucose in Fed (Absorptive) State
1.2.1.2 Glucose in Fasting (Postabsorptive) State
1.2.2 Glucose Uptake in Cellular Level
1.2.2.1 Glucose Transporter (GLUT)
1.2.2.2 Glycolysis
1.2.2.3 TCA Cycle and Oxidative Phosphorylation
1.2.2.4 Gluconeogenesis and Other Related Pathways
1.3 Glucose Metabolism in Brain
1.3.1 Brain Glucose Use
1.3.2 Central Regulation of Blood Glucose Levels
References
2: Pathophysiology and Risk Factors of Diabetes
2.1 Pathophysiology of Diabetes
2.1.1 Type 1 Diabetes Mellitus
2.1.1.1 Stages in the Natural History of T1DM
2.1.1.2 Genetic Considerations
2.1.1.3 Pathophysiology
2.1.1.4 Serologic Markers
2.1.1.5 Environmental Factors
2.1.2 Type 2 Diabetes Mellitus
2.1.2.1 Genetic Considerations
2.1.2.2 Pathophysiology
2.1.2.3 Insulin Resistance
2.1.2.4 Special Conditions Inducing Insulin Resistance
2.2 Risk Factors of Diabetes
References
3: Macro- and Microvascular Complications of Diabetes
3.1 Definitions of Macro- and Microvascular Complications of Diabetes
3.2 Macrovascular Complications: Atherosclerosis and Cardiovascular Disease
3.2.1 Atherosclerosis in Diabetes
3.2.2 Cardiovascular Diseases in Diabetes
3.3 Microvascular Complications: Retinopathy, Nephropathy, and Neuropathy
3.3.1 Diabetic Retinopathy
3.3.2 Diabetic Nephropathy
3.3.3 Diabetic Neuropathy
References
4: Hyperglycemia in Acute Stroke
4.1 Sterile Inflammation in Stroke
4.1.1 Inflammatory Cascades After Stroke
4.1.2 Targeting Brain Inflammation to Prevent Stroke Damage
4.2 Harmful Effects of Hyperglycemia on Brain Inflammation
4.2.1 Chronic Effects of Hyperglycemia on Brain Inflammation
4.2.2 Hyperglycemia After Ischemic Stroke
4.2.3 Mechanism of Brain Damage in Hyperglycemic Stroke Patients
4.3 Disadvantages of Hyperglycemia During the Treatment of Acute Stroke Patients
4.4 Conclusion
References
Part II: Clinical Significance of Diabetes in Cerebro-cardiovascular Disease
5: Clinical Impact of Diabetes Mellitus in Cardiovascular Diseases
5.1 Coronary Artery Disease
5.2 Peripheral Artery Disease
5.3 Hypertension, Atherosclerosis
5.4 Heart Failure
References
6: Epidemiology of Stroke Patients with Diabetes
6.1 Prevalence and Risk of Diabetes in Stroke
6.2 Clinical Significance of Diabetes in Stroke
6.2.1 Types of Stroke in Diabetic Patients
6.2.2 Initial Manifestations in Stroke Patients with Diabetes
6.2.3 Short- and Long-Term Outcomes in Stroke with Diabetes
6.2.4 Diabetic Complication and Stroke
6.3 Pre-Diabetes and Stroke
6.3.1 Prevalence of Pre-Diabetes in Stroke
6.3.2 Significance of Pre-Diabetes as a Stroke Risk Factor
6.3.3 Influence on Stroke Outcomes
References
7: Differential Influence of Diabetes on Stroke Subtype
7.1 Stroke Subtype: A Pathophysiological Overview
7.2 Ischemic Stroke as a Vascular Complication from Diabetes
7.2.1 Extracranial Atherosclerosis
7.2.2 Intracranial Atherosclerosis
7.2.3 Cerebral Microvasculopathy
7.2.4 Cardioembolism
7.3 Hemorrhagic Stroke
7.4 Summary
References
Part III: Treatment of Diabetes
8: Principles of Diabetes Care and Lifestyle Modification
8.1 Goal of Diabetes Management
8.1.1 Glycemic Control and Microvascular Complications in T1DM
8.1.2 Glycemic Control and Microvascular Complications in T2DM
8.1.3 Glycemic Control and Cardiovascular Outcomes in T1DM
8.1.4 Glycemic Control and Cardiovascular Outcomes in T2DM
8.1.5 Adverse Events of Intensive Glucose Control
8.1.6 Glycemic Goal
8.2 Assessment of Glycemic Control
8.2.1 HbA1c
8.2.2 Self-Monitoring of Blood Glucose (SMBG)
8.2.3 Continuous Glucose Monitoring (CGM) System
8.3 Lifestyle Modification
8.3.1 Medical Nutrition Therapy (MNT)
8.3.1.1 Total Energy Intake
8.3.1.2 Carbohydrates
8.3.1.3 Protein
8.3.1.4 Fat
8.3.1.5 Vitamins and Micronutrients
8.3.2 Exercise
8.4 Cardiovascular Risk Factor Control
8.4.1 Hypertension
8.4.2 Hyperlipidemia
8.4.2.1 Goal of Hyperlipidemia Management
8.4.2.2 Treatment of Hyperlipidemia
Lifestyle Modification
Statin
Statin and Ezetimibe Combination Therapy
Statin and PCSK9 Inhibitor Combination Therapy
Statin and Fibrate Combination Therapy
Statin and Omega-3 Fatty Acid Combination Therapy
Hypertriglyceridemia
8.4.3 Smoking Cessation
References
9: Metformin and Sulfonylurea
9.1 Metformin
9.2 Sulfonylureas/Meglitinides
References
10: Insulin Therapy
10.1 Insulin
10.1.1 Discovery of Insulin
10.1.2 Physiology
10.2 Insulin Therapy Strategy
10.2.1 Type of Insulin
10.2.2 Insulin Treatment
10.2.2.1 Insulin Treatment in Type 1 Diabetes
10.2.2.2 Insulin Treatment in Type 2 Diabetes
10.2.3 Insulin Treatment in Other Conditions
10.2.3.1 Gestational Diabetes (GDM)
10.2.3.2 Steroid Treatment
10.2.3.3 Severe Infection
10.2.3.4 Other Organ Failure
10.2.4 Special Consideration of Insulin Treatment in Stroke Patients
10.2.5 Adverse Effects on Insulin Treatment
10.2.5.1 Hypoglycemia
10.2.5.2 Somogyi Phenomenon
10.2.5.3 Dawn Phenomenon
10.2.5.4 Weight Gain
10.2.5.5 Insulin Edema
10.2.5.6 Insulin Allergy
10.2.5.7 Lipoatrophy or Lipohypertrophy
10.2.5.8 Safety
10.3 Future Perspectives
10.3.1 Artificial Pancreas
10.3.2 Pancreas and Islet Cell Transplantation
10.3.2.1 Pancreas Transplantation
10.3.2.2 Islet Cell Transplantation
References
11: Thiazolidinediones (TZDs)
11.1 History of TZD
11.2 Mechanism of Action
11.3 Clinical Effects of TZDs
11.3.1 Durability
11.3.2 Diabetes Prevention
11.3.3 Monotherapy
11.3.4 Combination Therapy
11.3.5 TZDs and Cardiovascular Diseases in Patients with T2DM
11.3.6 Non-diabetic Effects of TZDs
11.3.7 Adverse Effects
References
12: Dipeptidyl Peptidase-4 Inhibitors
12.1 History of DPP-4 Inhibitors
12.2 Mechanism of Action
12.3 Clinical Effects of DPP-4 Inhibitors
12.3.1 Glucose-Lowering Effects
12.3.2 Lipid-Lowering Effects
12.3.3 Cardiovascular Effects
12.3.4 Renoprotective Effects
12.3.5 Neuroprotective Effects
12.3.6 Effects on Bone
12.3.7 Effects on Immune System
12.3.8 Effects on the Skin
12.4 Summary
References
13: SGLT2 Inhibitors
13.1 History of SGLT2 Inhibitors
13.2 Mechanism of Action
13.3 Clinical Effects of SGLT2 Inhibitors
13.3.1 Glucose-Lowering Benefit
13.3.2 Weight Reduction
13.3.3 Blood Pressure Lowering Effect
13.3.4 Cardiorenal Protective Effect
13.3.4.1 MACE (CV Death, Non-Fatal MI, or Non-Fatal Stroke)
13.3.4.2 Renal Outcomes
13.3.4.3 HF
13.4 Conclusion
References
14: Glucagon-like Peptide-1 Receptor Agonists
14.1 History of GLP-1RAs
14.2 Mechanism of Action
14.2.1 Effects on Glycemic Control and Weight
14.2.2 Effects Beyond Glycemic Control
14.2.2.1 Effects on Pancreatic β Cells
14.2.2.2 Effects on Cardiovascular Risk Factors
14.2.2.3 Effects on the Heart and Endothelium
14.2.2.4 Effects on the Kidneys
14.3 Clinical Effects of GLP-1RAs
14.3.1 Effects of GLP-1RAs on Glycemic Control
14.3.2 Weight Reduction
14.3.3 Cardiovascular Effects
14.3.4 Renal Protection
14.3.5 Nonalcoholic Fatty Liver Disease
14.3.6 Tolerability Profiles of GLP-1RAs
14.3.6.1 Hypoglycemia
14.3.6.2 Gastrointestinal Effects
14.3.6.3 Injection-Site Reactions
14.3.6.4 Pancreatitis and Pancreatic Cancer
14.3.6.5 Medullary Thyroid Cancer
References
15: Standard Pharmacological Treatment of Diabetes Based on the Guidelines
15.1 History of Guidelines
15.2 Current Practice Guidelines of Diabetes
15.2.1 American Diabetes Association (ADA)/European Association for the Study of Diabetes (EASD) Consensus Report for Type 2 Diabetes Management
15.2.2 Korean Diabetes Association (KDA) Clinical Practice Guideline for Type 2 Diabetes
15.3 Selection of the Drugs in Stroke Patients
References
16: Future Therapies for Diabetes
16.1 Introduction
16.2 Human Pluripotent Stem Cells
16.3 Generation of Pancreatic Progenitor Cells and Beta Cells from hPSCs
16.4 Isolation of Pure hPSC-Derived Pancreatic Lines
16.5 Differentiation of Mature Cells or Adult Stem Cells
16.6 Cell-to-Cell Contact and Communication within Islets
16.7 Cell Encapsulation
16.8 Immune Modulation and Suicide Gene Strategies to Improve the Safety of Cell Therapy
16.9 Gene Therapy
16.10 Other Promising Therapies: Islet Xenotransplantation
16.10.1 Xenotransplantation Using Porcine Islets
16.10.2 Porcine Pancreatic Islet Transplantation Based on Official Regulations
16.10.3 Future Prospects for Porcine Islet Transplantation
16.11 Conclusion
References
Part IV: Actual Clinical Practice in Patients with Diabetes
17: Diabetes in Pregnancy
17.1 Gestational Diabetes
17.1.1 Prevalence
17.1.2 Risk Factors and Pathophysiology
17.1.3 Diagnosis
17.1.4 Treatment
17.2 Pre-Existing Diabetes in Pregnancy
17.2.1 Prevalence
17.2.2 Treatment
17.3 Clinical Consequences of Diabetes in Pregnancy
17.3.1 Short-Term Consequences
17.3.2 Long-Term Consequences
17.3.3 Stroke and Diabetes in Pregnancy
References
18: Glucose-Lowering Strategy in Acute Stroke
18.1 Basic Concept of Glucose Lowering in Acute Stroke
18.2 Clinical Trials for Intensive Glucose Control
18.3 Glycemic Control Strategy in Acute Stroke Patients
18.4 Conclusion and Future Perspective
References
19: Management of Acute Complications of Diabetes Mellitus
19.1 Hypoglycemia
19.1.1 Physiologic and Pathophysiologic Responses to Low Plasma Glucose Concentrations
19.1.2 Definition and Classification of Hypoglycemia in Diabetes Mellitus
19.1.3 Precipitating Factors for Hypoglycemia in Diabetes Mellitus
19.1.4 Clinical Presentation of Hypoglycemia
19.1.5 Management of Hypoglycemia in Diabetes Mellitus
19.1.6 Prevention of Hypoglycemia in Diabetes Mellitus
19.2 Diabetic Ketoacidosis (DKA) and Hyperosmolar Hyperglycemic State (HHS)
19.2.1 Pathophysiology of DKA and HHS
19.2.2 Precipitating Causes of DKA and HHS
19.2.3 Clinical Presentation of DKA and HHS
19.2.4 Diagnoses of DKA and HHS
19.2.5 Management of DKA and HHS
19.2.6 Prevention of DKA and HHS
References
20: Long-Term Glycemic Control for Stroke Survivors
20.1 Physical Activity, Weight Control, and Nutrition
20.1.1 Physical Activity
20.1.2 Weight Control and Nutrition
20.2 Pharmacological Management
20.2.1 Impact of Stroke Event on Glycemic Targets
20.2.2 Pharmacological Management
20.3 Risk Factor Control: Hypertension and Dyslipidemia
20.3.1 Hypertension
20.3.2 Dyslipidemia
20.4 Considerations during Rehabilitation
References