Insulin resistance and risk for stroke

W. N. Kernan, S. E. Inzucchi, C. M. Viscoli, L. M. Brass, Dawn Bravata, R. I. Horwitz

Research output: Contribution to journalArticle

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Abstract

Background and purpose: Resistance to insulin-mediated glucose uptake by peripheral tissues is a cardinal defect in type 2 diabetes mellitus. Insulin resistance is also common among nondiabetic individuals, and may be an important risk factor for stroke in both populations. The authors review the definition, epidemiology, and treatment of insulin resistance. Methods: The authors searched Medline (1977-2001) and reviewed bibliographies to identify pertinent English-language publications. Results: Insulin resistance is present in most patients with type 2 diabetes. It is also common among elderly persons, certain ethnic groups, and persons with hypertension, obesity, physical deconditioning, and vascular disease. The principal pathophysiologic defect is impaired intracellular signaling in muscle tissue leading to defective glycogen synthesis. Insulin resistance is associated with numerous metabolic, hematologic, and cellular events that promote atherosclerosis and coagulation. The association between insulin resistance and risk for stroke has been examined in four case-control studies and five prospective observational cohort studies. Six of the nine studies are methodologically sound and provide evidence that insulin resistance is associated with risk for stroke. Conclusion: Insulin resistance may be a prevalent risk factor for stroke. New drugs can safely reduce insulin resistance and may have a role in stroke prevention.

Original languageEnglish (US)
Pages (from-to)809-815
Number of pages7
JournalNeurology
Volume59
Issue number6
StatePublished - Sep 24 2002
Externally publishedYes

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Insulin Resistance
Stroke
Type 2 Diabetes Mellitus
Bibliography
Glycogen
Vascular Diseases
Ethnic Groups
Observational Studies
Publications
Case-Control Studies
Atherosclerosis
Epidemiology
Cohort Studies
Language
Obesity
Hypertension
Glucose
Muscles
Pharmaceutical Preparations
Population

ASJC Scopus subject areas

  • Neuroscience(all)

Cite this

Kernan, W. N., Inzucchi, S. E., Viscoli, C. M., Brass, L. M., Bravata, D., & Horwitz, R. I. (2002). Insulin resistance and risk for stroke. Neurology, 59(6), 809-815.

Insulin resistance and risk for stroke. / Kernan, W. N.; Inzucchi, S. E.; Viscoli, C. M.; Brass, L. M.; Bravata, Dawn; Horwitz, R. I.

In: Neurology, Vol. 59, No. 6, 24.09.2002, p. 809-815.

Research output: Contribution to journalArticle

Kernan, WN, Inzucchi, SE, Viscoli, CM, Brass, LM, Bravata, D & Horwitz, RI 2002, 'Insulin resistance and risk for stroke', Neurology, vol. 59, no. 6, pp. 809-815.
Kernan WN, Inzucchi SE, Viscoli CM, Brass LM, Bravata D, Horwitz RI. Insulin resistance and risk for stroke. Neurology. 2002 Sep 24;59(6):809-815.
Kernan, W. N. ; Inzucchi, S. E. ; Viscoli, C. M. ; Brass, L. M. ; Bravata, Dawn ; Horwitz, R. I. / Insulin resistance and risk for stroke. In: Neurology. 2002 ; Vol. 59, No. 6. pp. 809-815.
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