Value of glycosylated hemoglobin A_1c level to predicting recurrent cerebrovascular event in patients with type 2 diabetes mellitus complicated with ischemic stroke

Objective To explore the value of glycosylated hemoglobin A1c(HbA1c)to predicting the recurrent cerebrovascular event(RCE)in patients with type 2 diabetes mellitus(T2DM)complicated with ischemic stroke.Methods A total of 146 patients with T2 DM complicated with ischemic stroke were divided into high HbA1 c group(HbA1c≥6.0%)(n=87)and normal group(HbA1c6.0%)(n=59)according to the HbA1 c level at admission.The levels of fasting plasma glucose(FPG),2hpostprandial plasma glucose(PPG),total cholesterol(TC),triacylglycerol(TG),low density lipoprotein-cholesterol(LDL-C)and high density lipoprotein-cholesterol(HDL-C)one day after admission,as well as the degree of neurological damage at admission were compared between two groups.Both two groups received dehydration,antihypertension,improving cerebral circulation,nerve nutrition and plasma glucose controlling therapy.After continuous treatment for 3weeks,the therapeutic effect was assessed.After follow-up for 24 months,the incidence of RCE was calculated,and HbA1 c levels at admission were compared in patients with and without RCE.Results The levels of FPG((8.94±2.33)mmol/L),PPG((13.07±3.82)mmol/L),TC((6.09±1.37)mmol/L),TG((1.92±0.53)mmol/L)and LDL-C((4.11±1.13)mmol/L)were higher in high HbA1 c group than those in normal group(FPG:(6.72±2.61)mmol/L,PPG:(9.36±4.11)mmol/L,TC:(4.95±1.00)mmol/L,TG:(1.14±0.33)mmol/L,LDL-C:(2.98±1.05)mmol/L),and HDL-C was lower in high HbA1 c group((1.03±0.27)mmol/L)than that in normal group((1.45±0.34)mmol/L)one day after admission(P0.05).The incidence of moderate and severe neurological damage was higher in high HbA1 c group(87.36%)than that in control group(38.98%)at admission(P0.05).After 3-week treatment in both groups,the improvement rate was 75.86%in high HbA1 c group,significantly lower than that in normal group(94.92%)(P0.05).All patients were followed up for 24 months.RCE occurred in 45 patients.The HbA1 c level was(9.24±2.13)%in RCE patients,significantly higher than that in patients without RCE((6.07±1.86)%)at admission.Conclusion RCE occurs commonly in high-level HbA1 c T2DM patients complicated with ischemic stroke.Detection of HbA1 c level at admission contributes predicting the risk of RCE.