stroke

Posted on Diabetes

Risk of stroke increases with insulin resistance, study suggests


A study of more than 100,000 people with type 2 diabetes (T2D), presented at the annual meeting of the European Association for the Study of Diabetes (EASD), held online this year, found that insulin resistance is associated with stroke.

The higher the insulin resistance, the greater the risk of stroke, the research, from Dr Alexander Zabala and colleagues at the Karolinska Institute and researchers at Gothenburg University and the National Diabetes Registry in Sweden, found.

Insulin resistance – when the body’s cells don’t respond properly to insulin and can’t easily take up glucose from blood – is a key feature of T2D and levels vary from patient to patient.

Dr Zabala used estimated glucose disposal rate (eGDR) as a measure of insulin resistance.

eGDR has previously been shown to be a good proxy for insulin resistance and is calculated using a formula that factors in a patient’s waist circumference, HbA1c (average blood sugar level) and whether they have high blood pressure.

Health records were used to calculate the eGDR of 104,697 T2D patients in Sweden.  The participants had an average age of 63 and 44.5% were female.

They were followed up for an average of 5.6 years, during which 4,201 (4%) had a stroke. 

Analysis revealed that the higher a person’s insulin resistance, the greater their chance of having a stroke.  Those with the lowest insulin resistance (the highest eGDR) were 40% less likely to have a stroke than those with the highest insulin resistance.

Age, cholesterol levels, smoking, heart conditions and other traditional risk factors for stroke were all adjusted for.

The study also found that higher insulin resistance was linked to a higher risk of death after a stroke. Those with the lowest resistance were 28 per less likely to die during the follow-up period than those with the most severe insulin resistance.

Further analysis showed high blood pressure to be more strongly linked to stroke than waist circumference or HbA1c.

The study’s authors conclude: “We found that in individuals with type 2 diabetes, a low eGDR, a simple measure of insulin resistance, was associated with an increased risk of stroke and mortality.”

Dr Zabala adds: “eGDR could be used to help T2D patients better understand and manage their risk of stroke and death. 

“It could also be of importance in research.  In this era of personalised medicine, better stratification of type 2 diabetes patients will help optimise clinical trials and further vital research into treatment, diagnosis, care and prevention.”

Posted on Cardiovascular disease

More than one million stroke survivors live in fear of having another stroke

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More than one million(i) stroke survivors (89%) live in fear of having another stroke and are scared to go out alone (79%), leaving them afraid for their recovery (79%) in the aftermath of their stroke, according to a leading national charity. The Stroke Association’s startling new findings(ii) show how people’s recoveries are under threat from fear itself.

The charity’s latest research (of over 1,000 stroke survivors) also reveals the hidden barriers that people can face after stroke, often too scared to talk to anyone about: 

  • One in five (20%) stroke survivors said they kept their fears to themselves and didn’t talk to anyone
  • Over a third (37%) of these stroke survivors said they didn’t want to worry anyone; they were too afraid (27%) or didn’t want to sound stupid (26%) by talking about their fears.

On top of dealing with these fears and concerns, the study also shows that many stroke survivors are facing their recovery alone. This leads to a bleak attitude to recovery with almost nine in ten (88%) survivors afraid they won’t get better and four out of five (80%) fearing they would get sent to a care home when they first had their stroke. Fear prevents people from getting out and about and meeting others, two of the key factors that stroke survivors have said are integral to their recovery.

Juliet Bouverie, Chief Executive of the Stroke Association, said: “These stats are truly shocking. I am heart-broken to hear that stroke survivors felt they couldn’t speak to those closest to them about their biggest worries and fears. When you live in isolation, too afraid to leave the house and are unable to ask for help, your motivation can disappear, and can leave you in a very bad place emotionally – feeling like a prisoner in your own home.

“It takes a team to rebuild lives after stroke. When stroke strikes, part of your brain shuts down, and so does a part of you. Recovery is tough, but with the right specialist support, the brain can adapt after stroke. I’ve heard countless stories, and know countless people who, after many years continue to make remarkable recoveries. The first step to eliminating fear is to ask for help and support. If you are a stroke survivor, this could mean speaking to your doctor or social worker to get some answers. If you know a stroke survivor, reach out, ask them how they’re feeling. No one should have to live their life in constant fear.”

The Stroke Association’s research also found that:

  • Only 18% of stroke survivors were confident that they would get enough support to make a good recovery
  • 87% of stroke survivors said they feared losing their independence
  • 81% of stroke survivors said they were afraid they wouldn’t be able to look after their children or parents.

Juliet continues: “I was horrified to find out that there are still many people who feel helpless. People are missing out on the life they could have – this must change. Don’t be afraid to ask questions about your health. We want everyone to know that you can rebuild your life after stroke. Every stroke is different and so is every recovery. It can take years to adjust to a new normal.

“The Stroke Association’s Helpline is for everyone affected by stroke. There are no stupid questions. If you are worried about anything, call 0303 3033 100 and get support from one of our trained helpline staff.”

For more information about Rebuilding Lives or about stroke, visitwww.stroke.org.uk/rebuildinglives.

Posted on First Aid, Patient Talk

What To Do If Someone Has A Stroke – Signs & Symptoms –




Image result for What To Do If Someone Has A Stroke, Signs & Symptoms - First Aid Training - St John Ambulance




Find out more about what to do if someone is having a stroke and learn more about what a stroke is, causes, signs & symptoms here:

A St John Ambulance trainer demonstrates what to look for if someone is having a stroke and what to do to help.




Leave a comment Posted on Cardiovascular disease

Carotid endarterectomy – will you need one?




Carotid endarterectomy

Carotid endarterectomy

Carotid endarterectomy is a surgical procedure to unblock a carotid artery. The carotid arteries are the main blood vessels that supply the head and neck.




Carotid endarterectomies are carried out when one or both carotid arteries become narrowed because of a build-up of fatty deposits (plaque). This is known as carotid artery disease or carotid artery stenosis.

If a narrowed carotid artery is left untreated, blood flow to the brain may be affected. This is usually because a blood clot forms and a piece breaks off and goes to the brain. This can result in either:

a stroke – a serious medical condition that can cause brain damage or death

a transient ischaemic attack (TIA) – sometimes known as a “mini-stroke”, a TIA is similar to a stroke but the signs and symptoms are temporary and usually disappear within 24 hours

Each year around 110,000 people have a stroke in the UK and around a quarter of these are caused by a narrowing of the carotid arteries. More than 5,000 carotid endarterectomy procedures were performed on the NHS between 2011 and 2012.

Carotid endarterectomy can significantly reduce the risk of a stroke in people with severely narrowed carotid arteries. In people who have previously had a stroke or a TIA, their risk of having another stroke or TIA within the next three years is reduced by a third after surgery.

It’s now thought the operation should be performed as soon as possible after symptoms appear. It’s important to seek immediate medical advice if you experience symptoms such as:

numbness or weakness in the face, arm or leg

speech problems

loss of vision in one eye

Read more about when carotid endarterectomy is needed.

About the procedure

Carotid endarterectomy can be carried out using either local anaesthetic or general anaesthetic. The advantage of local anaesthetic is it allows the surgeon to monitor brain function while you’re awake. However, there’s no evidence that either is safer or better.




During the procedure, a 7-10cm (2.5-4 inch) cut will be made between the corner of your jaw and your breastbone. A small cut is then made along the narrowed section of artery, and the fatty deposits that have built up are removed.

The artery is then closed with stitches or a patch and your skin is also closed with stitches.

Read more about:

getting ready for carotid endarterectomy

how carotid endarterectomy is performed

What happens after the procedure

You’ll usually be moved to the recovery area of the operating theatre for monitoring. Most people are well enough to go home within about 48 hours of the procedure.

In most cases, the only problems experienced after the operation are temporary numbness or discomfort in the neck.

However, there’s a small risk of more serious complications, which can include stroke or death in around 3% of cases. Nevertheless, this risk is much lower than in people with carotid artery disease who haven’t chosen to have the operation.

Read more about:

recovering from carotid endarterectomy

risks of carotid endarterectomy

Are there any alternatives?

Carotid endarterectomy is the main treatment for narrowing of the carotid arteries, but sometimes an alternative procedure called carotid artery stent placement may be available.

This is a less invasive procedure than a carotid endarterectomy because it doesn’t involve a cut being made in the neck. Instead, a thin flexible tube is guided to the carotid artery through a small cut in the groin. A mesh cylinder (stent) is then placed into the narrowed section of artery to widen it and allow blood to flow through it more easily.

Carotid stenting is currently thought to be associated with a higher risk of stroke during the procedure, especially if it’s performed in the first few days after symptoms appear. However, it’s a useful alternative for people who may be at a higher risk of complications from an operation.

Read more about carotid artery stent placement.

Leave a comment Posted on Multiple Sclerosis, Patient Talk

Pseudobulbar Affect – a possible symptom of multiple sclerosis




Pseudobulbar Affect

Pseudobulbar Affect




As regular readers know we try to look at rarer signs and symptoms of multiple sclerosis.

You might be interested in this video on lesser known symptoms of multiple sclerosis.

Pseudobulbar affect ( also known as emotional incontinence) can occur with multiple sclerosis, strokes and Parkinson’s for example. It is medical condition characterized by sudden and uncontrollable episodes of crying or laughing.

The American Stroke Association have produced and excellent video on Pseudobulbar Affect. We really recommend you watch.

Thanks in advance!