Reducing the risk of stroke in type 2 diabetes: pathophysiological and therapeutic perspectives |
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Authors: | Dirk Sander Mark T Kearney |
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Institution: | (1) Department of Neurology, Medical Park Hospital, Thanngasse 15, 83483 Bischofswiesen, Germany;(2) Department of Neurology, University of Technology, Ismaninger Strasse 22, 81675 Munich, Germany;(3) The LIGHT Laboratories, Institute for Genetics, Health and Therapeutics, University of Leeds, Leeds, UK |
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Abstract: | Reducing the excess cerebrovascular burden in patients with type 2 diabetes remains a major therapeutic challenge, especially
with respect to the high risk of recurrent events. Targeting the traditional metabolic risk factors of hypertension, dyslipidemia,
and hyperglycemia has failed to remove this excess risk, and agents targeting thrombotic risk (i.e., antiplatelet and anticoagulant
drugs) remain poorly studied in the context of stroke in diabetes. This may relate to the accumulation of risk factors in
type 2 diabetes as well as to diabetes-specific pathophysiologic factors. Regrettably, there is a lack of prospective evidence
to support the efficacy of interventions in the secondary prevention of cerebrovascular events in type 2 diabetes, particularly
recurrent stroke events. Overall, there is a need for rigorous evaluations of new therapeutic approaches in both primary and
secondary prevention of stroke and management of acute stroke in patients with type 2 diabetes. This systematic review of
the published literature summarizes the evidence regarding current therapeutic interventions and their impact on the risk
of stroke in people with type 2 diabetes, and highlights potential strategies for improving outcomes. |
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