Higher Glucose Levels May Contribute to Faster Cognitive Decline in Stroke Survivors

Will this prompt your stroke hospital to create protocols for testing this and then followup protocols to prevent cognitive decline from happening? Or is your hospital incompetent in not even knowing about this?

Do you prefer your  doctor and hospital incompetence NOT KNOWING? OR NOT DOING?

Higher Glucose Levels May Contribute to Faster Cognitive Decline in Stroke Survivors

Higher cumulative glucose levels may contribute to faster cognitive decline in stroke survivors, representing a potential treatment target to preserve cognition after stroke, according to a study published in JAMA Network Open.

“Having a stroke increases a person’s risk of dementia up to 50-fold,

but we lack a comprehensive treatment approach that could reduce this risk, other than preventing a second stroke,” said Deborah A. Levine, MD, University of Michigan Medical School, Ann Arbor, Michigan. “These findings suggest that higher cumulative blood sugar levels after stroke contribute to faster cognitive decline, and hyperglycaemia after stroke, regardless of diabetes status, could be a potential treatment target to protect post-stroke cognition.”

Dr. Levine and colleagues evaluated associations of post-stroke systolic blood pressure (BP), glucose, and low-density lipoprotein (LDL) cholesterol levels with cognitive decline by conducting a meta-analysis of 4 US cohort studies (conducted 1971-2019) that included 982 dementia-free individuals (48.9% female; 29.4% Black).

The median age at incident stroke was 74.6 years. Cumulative mean post-stroke systolic BP and LDL cholesterol levels were not associated with any cognitive outcome. However, after accounting for cumulative mean post-stroke systolic BP and LDL cholesterol levels, higher cumulative mean post-stroke glucose level was associated with faster decline in global cognition (-0.04 points/y faster per each 10 mg/dL increase; P = .046) but not executive function or memory.

After restricting to 798 participants with apolipoprotein E4 (APOE4) data and controlling for APOE4 and APOE4 × time, higher cumulative mean post-stroke glucose level was associated with a faster decline in global cognition in models without and with adjustment for cumulative mean post-stroke systolic BP and LDL cholesterol levels (-0.05 points/y faster per 10 mg/dL increase, P = .01; -0.07 points/y faster per 10 mg/dL increase, P = .002) but not executive function or memory declines.

Dr. Levine noted that the new study suggests the need for clinical research to test whether tight glycaemic control in stroke survivors reduces post-stroke cognitive decline and dementia in those with and without diagnosed diabetes.

Tight glycaemic control has been shown in people with diabetes to reduce small blood vessel complications in the eyes, kidney, and nerves, and may have the potential to also decrease small blood vessel disease in the brain, but this is unproven.

Reference: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2805003

SOURCE: Michigan Medicine - University of Michigan