Relationship Between Diabetes Mellitus and Cerebral Infarction Particularly Regarding Treatment in the Elderly: Retrospective Study

Abstract

Ground factors, such as the age at death, complcation of hypertension and atrial fibrillation. The age at initial examinations (the age at the onset) and fasting glucose levels exceeding 140 mg/dl at initial examinations were significantly higher in the SU group than in the F group (p<0.01) and the incidence of severe cerebral arteriosclerosis tended to be higher in the SU group than in the F group (p<0.1). 3. When the background factors were compared by the presence or absence of large infarction in the SU group, the incidence of hypoglycemia was significantly higher in the patients with large infarction (p<0.05) and that of the fasting glucose levels higher than 140 mg/dl at initial examinations tended to be higher (p<0.1) in cases with large infarction. From the above results, special care should be paid in the administration of SU for the elderly diabetic patients with possible severe cerebral arteriosclerosis, to prevent large cerebral infarction which might be related to hypoglycemia. This study was done at the Yokufukai Geriatric Hospital to examine the relationship between diabetes mellitus and large cerebral infarction (confirmed by autopsy in all cases) in 590 cases aged 60 years and over. The cases were grouped into the diabetes mellitus group (DM) and the non-diabetes mellitus group (N-DM). The background factors, possibly related to the development of cerebral infarction were also compared in these two groups. 1. No significant difference was noted in the incidence of large cerebral infarction between the DM and N-DM. As for DM therapy, large cerebral infarction occurred in 22.5% of the sulfonylurea groups (SU) and the incidence was roughly 6.8 times (p<0.01) as high as that of the dietary alone groups (F) and 2.6 times of the N-DM group. In cases with hypertension of the SU group, the incidence was 7.2 times (p<0.01) as high as that of the F group and 2.5 times (p<0.02) that of the N-DM group. 2. No significant difference was recognized between the SU group and the F group in the back. © 1987, The Japan Geriatrics Society. All rights reserved.