From diabetic hyperglycemia to cerebrovascular Damage: A narrative review

• Published in: Brain research 2023-12, Vol.1821, p.148611-148611, Article 148611
• Main Authors: Simon Machado, Richard, Mathias, Khiany, Joaquim, Larissa, Willig de Quadros, Rafaella, Petronilho, Fabricia, Tezza Rezin, Gislaine
• Format: Article
• Language: English
• Subjects: Cerebrovascular; Diabetes mellitus; Glucose; Hyperglycemia; Ischemic stroke
• ISSN: 0006-8993; 1872-6240
• DOI: 10.1016/j.brainres.2023.148611

•Hyperglycemia results in brain damage through glucose metabolic pathways.•Oxidative stress and neuroinflammation are exacerbated by hyperglycemia.•Glucose is diverted into pathways that increase damage to the CNS in hyperglycemia.•Diabetic hyperglycemia increases the occurrence of ischemic stroke. Diabetes mellitus is a globally significant disease that can lead to systemic complications, particularly vascular damage, including cardiovascular and cerebrovascular diseases of relevance. The physiological changes resulting from the imbalance in blood glucose levels play a crucial role in initiating vascular endothelial damage. Elevated glucose levels can also penetrate the central nervous system, triggering diabetic encephalopathy characterized by oxidative damage to brain components and activation of alternative and neurotoxic pathways. This brain damage increases the risk of ischemic stroke, a leading cause of mortality worldwide and a major cause of disability among surviving patients. The aim of this review is to highlight important pathways related to hyperglycemic damage that extend to the brain and result in vascular dysfunction, ultimately leading to the occurrence of a stroke. Understanding how diabetes mellitus contributes to the development of ischemic stroke and its impact on patient outcomes is crucial for implementing therapeutic strategies that reduce the incidence of diabetes mellitus and its complications, ultimately decreasing morbidity and mortality associated with the disease.