Hyperglycaemic Metabolic Complications of Ischemic Brain: Current Therapeutics, Anti-Diabetics and Stem Cell Therapy

Abstract

Abstract: Stroke is the leading cause of morbidity and mortality in diabetic patients. Diabetes alters the endothelial function and disrupts brain pathways, resulting in a variety of systemic metabolic complications. Diabetics not only have impaired neurotransmission, but also have progressive neurodegeneration, which leads to long-term neurological complications. Diabetes risk factors and physiology alter the frequency and severity of cardiovascular and cerebrovascular events, necessitating more hospitalizations. Stroke and diabetes have a mutually reinforcing relationship that worsens their outcomes. Diabetes has far-reaching systemic consequences for human physiology as a metabolic syndrome. As a result, diabetic stroke patients require dual-therapeutics with dual protection. Scientific researchers have made tremendous progress in diabetes-related stroke and its therapeutics over the last few decades. We have summarised diabetic brain and associated risk factors, co-morbidities, biomarkers, and hyperglycemia-associated neurovascular insult and cognitive demur. In addition to providing an overview of the effects of hyperglycaemia on brain physiology, this article aims to summarise the evidence from current glucose-lowering treatment, recent advances in stroke therapeutics as well as exploring stem cell therapy in the management of diabetes-associated stroke.