Researchers identify mechanism in diabetics that increases stroke risk

Strokes pose a tremendous risk for individuals with type 1 or type 2 diabetes. They are much more likely to experience uncontrolled bleeding in the brain during a stroke, which increases the risk of poor outcomes and death.

However, a team of researchers from Joslin Diabetes Center may have found the mechanism that makes diabetics more prone to bleeding during strokes, according to their report, which was published in the journal Nature Medicine. This may pave the way for improved treatments that reduce their risk of adverse outcomes.

While studying lab mice, the researchers found that a particular protein called plasma kallikrein interferes with the normal clotting activity of blood. Furthermore, elevated blood sugar levels increase the amount of this protein in the brain. However, testing also showed that when this protein is blocked in diabetic mice, it limits bleeding during a stroke.

"Given the prevalence of strokes and the damage they inflict, these findings are exciting because they suggest the possibility that rapid control of blood sugar levels may provide an opportunity to reduce intracerebral hemorrhage, which is a clinical situation that has very limited treatment options," said Dr. Edward Feener, who led the study.

Feener added that the results also show that it is not diabetes that increases the risk of bleeding during a stroke, rather it is high blood sugar levels. This may make the findings relevant to the millions of people who have pre-diabetes, as well as those with full diabetes.

The findings also raise hope for the development of a new drug that blocks the action of plasma kallikrein in the event of a stroke. The researchers said that this could be the next step in their studies.
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