Abstract
Diabetic macroangiopathy, especially cerebrovascular disease, is becoming a more serious problem in diabetes mellitus patients as life-spans increase. In this study, we attempted to clarify clinical features of cerebrovascular disease in diabetic patients.
Clinical features of cerebrovascular disease were studied in 69 diabetic patients admitted to our hospitals over a 5 year period (1987-1992). Furthermore, we examined changes in blood pressure and HbA1c before the onset of cerebral infarction in 24 patients.
Cerebral infarction (90%), transient ischemic attack (6%) and cerebral hemorrhage (4%) were diagnosed. Thirty patients (53%) had multiple lesions and 35 patients (61%) suffered from lacunar infarctions of penetrating arteries. The distribution of ages at onset of cerebral infarction showed two peaks. The patients could be divided into two groups; a middle aged group (65 years old and under) and an elderly group (66 years old and over). Significantly higher levels of hemoglobin A1 c, triglyceride and uric acid were observed in the middle aged group than in the elderly group. Significant declines in systolic blood pressure, before the onset of cerebral infarction, were observed in the group receiving hypotensive medications.
These findings suggest that small, multiple cerebral infarctions are characteristic of diabetic patients, and that metabolic disturbances accompanying diabetes mellitus may accelerate the onset of cerebral infarction. It is suggested that there is a relationship between a blood pressure fall and an episode of cerebral infarction.
