1. Cerebro-Vascular Pathology of Elderly diabetics 72 case-studies S. Hannat - R. Chermat - R. Malek Internal Medical Service University Hospital Centre Setif Algeria Malta, April 23–26, 2009

2. Introduction Stroke affects more than 700,000 individuals each year. it is the third largest cause of death and the largest cause of adult disability in the U.S A (1). Diabetes is clearly one of the most important risk factors for ischemic stroke(2). Diabetes is associated with an increased incidence of stroke and death among elderly people (3) (1)Stroke. 2008;39:1142-1147. (2) Diabetes Care 30:3131-3140, 2007 (3) Journal of Gerontology 2004, Vol. 59A, No. 6, 640–645

3. Objectives Estimate the incidence of stroke among hospitalized diabetics. Analyze the type and the progression of the stroke Characteristics of the elderly patient

4. Patients and Methodology Retrospective study Target population: elderly diabetics Duration: 3 years Parameters studied: - age, gender, onset of diabetes, lipid check up, HbA1c - Check up of complications - Associeted causes of morbidity

5. Number of stroke among elderly diabetics / Total number of hospitalized diabetics 803 72 9% ±1,96 (95% CI 7,04 to 10,96)

6. Number of stroke among elderly diabetics / Total number of stroke 157 72 46% ± 7,78 (95% CI 54 to 38) Total number of stroke Number of stroke among elderly diabetics

7. Distribution by gender Blood glucose control on admission Ratio 1M / 2W Total number of stroke 72 Averrage lenght of the evolution of diabetes : 10 years ± 3,76 years Men Woman 24 48 HbA1c % < 7% 9 % >7% et < 10 % 46% > 10% 45 %

8. Distribution by age range « Young-old » 65 - 74 years « Middle-old» 75 - 84 years « Old-old» over 85 years Elderly adult : WHO > 65 years Woman Men (y)

9. Type of stroke Short Term Progress 87% 13% ischemic haemorrhagic 73,6% 19,4% 6,94%

10. Associated cardio-vasculars risk factors 85% 34,4% 7% 10% 3%

11. Comments Stroke is common in elderly diabetics. 9 % hospitalized diabetics had stroke. 46% of all stroke victims are elderly diabetics A majority of stroke victims are women (gender ratio 0,5). The highest frequency of stroke victims is in the 65-74 years age range.

12. Comments The onset of type II diabetes as well as chronic imbalance could be risk factors in the occurance of a complication. Ischemic stroke is the predominant type. The risk is usually higher among hypertensive elderly diabetics with atrial fibrillation or previous stroke. Immediate progress : High mortality rate (20% of cases).

13. Conclusion The risk of ischemic stroke is higher among elderly diabetics. L’HTA, atrial fibrilation, chronic métabolit imbalance, previous stroke incidents are determining factors This complication has a hight probality of resuiting in disability or death.