Acute stroke in women: features of detection and correction of carbohydrate disorders
Background. Acute stroke (AS) remains one of the major health issues for women worldwide. Among the risk factors for AS in women, there are age, race, smoking, reduced physical activity, diabetes mellitus (DM) and other carbohydrate metabolism disorders. The purpose was to analyze the features of the occurrence of carbohydrate metabolism disorders in women with AS and to improve the diagnosis of these disorders. Materials and methods. Four hundred and sixteen case histories of patients with AS were analyzed by studying passport and anamnestic data, objective examination, laboratory and instrumental research methods. Based on the results of this analysis, a scheme was created for the detection of DM and other carbohydrate metabolism disorders in patients with AS. In the second stage, 346 patients were examined and divided into three groups: 1) AS against the background of DM; 2) prediabetes conditions (fasting hyperglycemia, postprandial hyperglycemia, transient (stress) hyperglycemia); 3) persons without DM. Patients of these groups did not differ in terms of basic anthropometric, clinical and instrumental characteristics. Results. Various carbohydrate metabolism disorders occurred in 227 of 346 patients with AS included in the experimental groups (65.6 % of cases). Women had carbohydrate metabolism disorders more frequently - 118 of 171 (69.01 %) cases, but this difference with men (109 patients, 62.28 %) did not reach statistical significance level (p > 0.05). In 29 (6.97 %) patients, DM was not diagnosed, despite the clinical picture and changes in fasting glycemia, and hyperglycemia in these patients was considered as transient and was not corrected in a timely manner. Conclusions. Routine evaluation of fasting glycemia is not sufficient to detect DM and other carbohydrate metabolism disorders in women with AS. The level of glycosylated hemoglobin does not give a complete picture of the presence of the disease, but is useful for assessing the degree of DM compensation. Oral glucose tolerance test allows us to improve the quality of diagnosis and to optimize the treatment for AS. This test revealed 16 new cases of DM (including 8 in women) and 28 patients (15 women) with other carbohydrate metabolism disorders.