Influence of Diabetes Mellitus on the Incident of Stroke: Meta-Analysis
Abstract
Blood vessel disorders can occur due to the narrowing and hardening of the artery walls, which is called atherosclerotic plaque. Stroke is a serious health problem because of the high mortality and morbidity rates and its impact can cause chronic disability and occurs not only in elderly people but also in young people. This study aims to estimate and analyze the effect of diabetes mellitus on the incidence of stroke. This research is a systematic review and meta-analysis research using the PRISMA diagram. Article searches were carried out based on the PICO Model eligibility criteria. P= DM patient; I= Diabetes mellitus; C= Normal blood sugar; O= Stroke. The articles used come from Google Scholar. With keywords including "Diabetes mellitus" AND "Normal blood sugar" AND "Stroke" AND "adjusted Odds Ratio". Articles were analyzed using the PRISMA diagram and the Review Manager 5.3 application. 5 articles (2016-2022) with a randomized controlled trial study design will be used as a source for meta-analysis of the effect of diabetes mellitus on the incidence of stroke. Shows that people with diabetes mellitus increase the likelihood of stroke. Patients suffering from diabetes mellitus increase the likelihood of stroke by 2.41 times compared to those with normal blood sugar. (aOR= 2.41; 95% CI= 1.71 to 3.39; p=0.0001), and statistically significant. The forest plot also shows high heterogeneity of effect estimates between studies (I2 = 73%). The funnel plot shows that there is publication bias which tends to exaggerate the true effect (overestimate). Meta-analysis of 5 studies cross-sectional concluded that people with diabetes mellitus increase the likelihood of stroke.
References
Al-Eithan, M.H., Amin, M., & Robert, A.A. (2011). The effect of hemiplegia/hemiparesis, diabetes mellitus, and hypertension on hospital length of stay after stroke. Neurosciences, 16(3), 253–256.¬
Ariva, SN, Handayani, F., Nur, M., & Liwang, I. (2022). Comparison of Severity of Non-Hemorrhagic Stroke With Diabetes Mellitus (Dm) Type 2 and Without Diabetes Mellitus (Dm) Type 2 Based on Nihss. 13(02), 520–525.
Chehaibi, K., Nouira, S., Mahdouani, K., Hamdi, S., Rouis, M., & Slimane, M.N. (2014). Effect of the PPARγ C161T Gene Variant on Serum Lipids in Ischemic Stroke Patients with and Without Type 2 Diabetes Mellitus. Journal of Molecular Neuroscience, 54(4), 730–738. https://doi.org/10.1007/s12031-014-0326-3
Gudi, J., Malleshappa, A., Ravishankar Naik, K., & S Sonoli, S. (2019). Effect of diabetes mellitus on the diagnostic efficacy of ischemia modified albumin in acute stroke. International Journal of Clinical Biochemistry and Research, 6(1), 36–40. https://doi.org/10.18231/2394-6377.2019.0010
Han, B.H., Han, K., Yoon, K.H., Kim, M.K., & Lee, S.H. (2020). Impact of mean and variability of high-density lipoprotein-cholesterol on the risk of myocardial infarction, stroke, and mortality in the general population. Journal of the American Heart Association, 9(7). https://doi.org/10.1161/-JAHA.119.015493
Hong, P., Gu, R.N., Li, F.X., Xiong, XX, Liang, W. Bin, You, Z.J., & Zhang, H.F. (2019). NLRP3 inflammasome as a potential treatment in ischemic stroke concomitant with diabetes. Journal of Neuroinflammation, 16(1), 1–13. https://doi.org/10.1186/s12974-019-1498-0
Indarto, I., Widiyanto, A., & Atmojo, J. T. (2023). Efektivitas Metformin dalam Penurunan Kadar Glukosa pada Pasien Diabetes Mellitus Tipe-2: Meta-Analisis. Jurnal Ilmiah Permas: Jurnal Ilmiah STIKES Kendal, 13(2), 621-630.
Isaman, DJM, Herman, W.H., & Ye, W. (2021). Prediction of transient ischemic attack and minor stroke in people with type 2 diabetes mellitus. Journal of Diabetes and Its Complications, 35(7), 107911. https://doi.org/¬10.1016/-j.jdiacomp.2021.107911
Kang, YN, Shen, HN, Lin, CY, Elwyn, G., Huang, S.C., Wu, T.F., & Hou, W.H. (2019). Does a Mobile app improve patients' knowledge of stroke risk factors and health-related quality of life in patients with stroke? A randomized controlled trial. BMC Medical Informatics and Decision Making, 19(1), 1–9. https://doi.org/10.1186/s12911-019-1000-z
UNS Public Health. (2023). Quality Assessment of Primary Studies for. 36, 3–4.
Kezerle, L., Haim, M., Akriv, A., Senderey, A.B., Bachrach, A., Leventer-Roberts, M., & Tsadok, M.A. (2022). Relation of Hemoglobin A1C Levels to Risk of Ischemic Stroke and Mortality in Patients With Diabetes Mellitus and Atrial Fibrillation. American Journal of Cardiology, 172(514), 48–53. https://doi.org/¬10.1016/j.amjcard.2022.02.024
Kurnianto, A., & Pramukarso, DT (2019). Effect of Simvastatin on Carotid Intima-Media Thickness in Ischemic Stroke Patients with Type 2 Diabetes Mellitus. Medica Hospitalia: Journal of Clinical Medicine, 6(1), 20–23. https://doi.org/10.36408/mhjcm.v6i1.373
Lim, S., Oh, T. J., Dawson, J., & Sattar, N. (2020). Diabetes drugs and stroke risk: Intensive versus conventional glucose-lowering strategies, and implications of recent cardiovascular outcome trials. Diabetes, Obesity and Metabolism, 22(1), 6–15. https://doi.org/10.1111/dom.13850
Marso, S.P., Kennedy, K.F., House, JA, & McGuire, D.K. (2010). The effect of intensive glucose control on all-cause and cardiovascular mortality, myocardial infarction and stroke in persons with type 2 diabetes mellitus: A systematic review and meta-analysis. Diabetes and Vascular Disease Research, 7(2), 119–130. https://doi.org/10.1177/1479164109353367
Mohammad, Y. (2020). Siesta and risk for ischemic stroke: Results from a case-control study. Medicina (Lithuania), 56(5). https://doi.org/10.3390/-medicina56050222
Oyarce-calderón, A.M. (2023). Lifestyle Risk Factors Associated with Stroke in Patients with Type 2 Diabetes Mellitus : A Case-control Study Abstract : 1–8. https://doi.org/10.2174/18749445-v16-230726-2023-56
Pitt, B., Steg, G., Leiter, L. A., & Bhatt, D. L. (2022). The Role of Combined SGLT1/SGLT2 Inhibition in Reducing the Incidence of Stroke and Myocardial Infarction in Patients with Type 2 Diabetes Mellitus. Cardiovascular Drugs and Therapy, 36(3), 561–567. https://doi.org/10.1007/s10557-021-07291-y
Sarfo, F.S., Ovbiagele, B., Akpa, O., Akpalu, A., Wahab, K., Obiako, R., Komolafe, M., Owolabi, L., Ogbole, G., Calys-Tagoe, B. , Fakunle, A., Sanni, T., Mulugeta, G., Abdul, S., Akintunde, AA, Olowookere, S., Uvere, E.O., Ibinaiye, P., Akinyemi, J., Owolabi, M. ( 2022). Risk Factor Characterization of Ischemic Stroke Subtypes among West Africans. Stroke, 53(1), 134–144. https://doi.org/10.1161/STROKEAHA.120.032072
Tsivgoulis, G., Katsanos, A.H., Mavridis, D., Lambadiari, V., Roffe, C., MacLeod, M.J., Sevcik, P., Cappellari, M., Nevšímalová, M., Toni, D., & Ahmed , N. (2019). Association of baseline hyperglycemia with outcomes of patients with and without diabetes with acute ischemic stroke treated with intravenous thrombolysis: A propensity score-matched analysis from the SITS-ISTR registry. Diabetes, 68(9), 1861–1869. https://doi.org/10.2337/db19-0440
Widiyanto, A., Wahyu, A. S., Mubarok, A. S., Anshori, M. L., Mukhofi, L., Pradana, K. A., & Atmojo, J. T. (2022). Pengabdian Masyarakat Pendidikan Kesehatan Tentang Manfaat Senam Diabetes Pada Lansia Di Desa Garangan, Wonosamodro, Boyolali. Buletin Abdi Masyarakat, 2(2).
Zaki, N., Alashwal, H., & Ibrahim, S. (2020). Association of hypertension, diabetes, stroke, cancer, kidney disease, and high-cholesterol with COVID-19 disease severity and fatality: A systematic review. Diabetes and Metabolic Syndrome: Clinical Research and Reviews, 14(5), 1133–1142. https://doi.org/¬10.1016/j.dsx.2020.07.005
Zhao, L., Tan, S., Liao, Q., Li, X., Ke, T., & Li, S. (2021). The neuroprotective effect and RNA-sequence analysis of postconditioning on ischemic stroke with diabetes mellitus tree shrew model. Brain and Behavior, 11(11), 1–9. https://doi.org/10.1002/brb3.2354
Zhu, B., Pan, Y., Jing, J., Meng, X., Zhao, X., Liu, L., Wang, Y., Wang, Y., & Wang, Z. (2019). Stress Hyperglycemia and Outcome of Non-diabetic Patients After Acute Ischemic Stroke. Frontiers in Neurology, 10(September), 1–8. https://doi.org/10.3389/fneur.2019.01003.
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