Vnitr Lek 2003, 49(12):916-920

[Diabetes mellitus cerebrovascular disease].

M Soucek: II. interní klinika Lékarské fakulty MU a FN u sv. Anny, Brno.

Cerebral vascular accident (CVA) is the second leading cause of deaths in developed countries. The mortality rate from CVA in the Czech Republic in people under 65 years is twice higher compared to countries in Western and Northern Europe. Every year it affects about 500/100,000 citizens with mortality within one year approximately in 45%. Incidence of this serious disease is three times more frequent in diabetics than in non-diabetics. After ictus, the prognosis is worse and repeated cerebral strokes more frequent. From the risk factors, diabetics usually suffer from hypertension which is part of a complex of metabolic syndrome X. There are more frequent carotid stenoses and impaired tiny arteries in diabetics compared to non-diabetic population. Recently, it has been pointed at an importance of early detection of hyperglycaemia in ischemic brain accidents, because hyperglycaemia seriously affects ischemic brain tissue. Apart from other things, it leads to impairment of motor functions. A specialist providing care to diabetics must consider and start treatment of all the risk factors. Under ideal conditions, every diabetic should be excellently compensated and have normal blood pressure values, low concentrations of LDL cholesterol, and should be treated with ACE inhibitor at the same time as with acetylsalicylic acid and clopidogrel.