How to manage Diabetes in the
acute vascular accident ?
Ines KHOCHTALI (Monastir, Tunisia)
INTRODUCTION
•Diabetes : Huge problem
•Under diagnosed
•Cardiovascular (CV) disease is the primary complication of diabetes;
approximately 65% of deaths in people with diabetes are due to
heart disease.
•Three-quarters are attributable to coronary artery disease and the
remainder to cerebrovascular or peripheral vascular events.
•Hyperglycemia is an independant predictor of mortality
•Each 1% increase in HbA1c poses 28% relative risk of cardiovascular
event
Lancet 2000: 355: 773-8
Haffner SM et al. N Engl J Med. 1998;339:229-234.
01 2 3 4 5 6 7 8
0
20
40
60
80
100
No diabetes, no MI (n=1,304)
diabetes no MI (n=890)
No diabetes with MI (n=69)
Diabetes with MI (n=169)
Survey (%)
YEARS
Cardiovascular mortality
Pathophysiology:
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
1
/
49
100%
