An MRI 3 Tesla scan of the brain at Tam Anh General Hospital, Ho Chi Minh City, revealed Mr. Viet had multiple brain infarcts. His blood sugar at the time was 250,6 mg/dL, four times higher than normal.

Diagnosed with an acute cerebral infarction in its third hour, Mr. Viet immediately received thrombolytic medication from the emergency team to restore blood flow. Subcutaneous insulin was also administered to stabilize his dangerously high blood sugar.

Doctor Tuyen checks Mr. Viet's health. *Photo: Tam Anh General Hospital*

Following 30 minutes of intervention, Mr. Viet responded well to the medication, showing improved muscle strength. He was then transferred to the Endocrinology - Diabetes Department for continued disease management and rehabilitation. His care plan included close monitoring of blood sugar levels and consistent physical therapy to gradually restore function to the left side of his body.

While Mr. Viet was screened for other potential risk factors for cerebral infarction, such as atherosclerosis, vascular disease, atrial fibrillation, and cardiac thrombi, no abnormalities were found. "The exact cause of the patient's cerebral infarction is not yet clear, but his more than 10-year history of diabetes with poorly controlled blood sugar is a factor that increases stroke risk," said Master of Science, Doctor Nguyen Thi Kim Tuyen, from the Endocrinology - Diabetes Department.

Doctor Tuyen further explained that individuals with diabetes face a 2 to 6 times higher risk of stroke compared to healthy individuals. This elevated risk is often attributed to chronically high blood sugar, which can trigger inflammatory responses. These responses contribute to conditions like atherosclerosis, hypertension, and ischemia. Additionally, diabetics typically have higher levels of bad cholesterol in their blood, which can easily form blood clots that obstruct or rupture the blood vessels supplying the brain.

After two weeks of treatment, Mr. Viet could move slowly, although he still experienced difficulty speaking and slurred speech. He was discharged to continue his rehabilitation at home. To prevent stroke recurrence and more severe complications, he must strictly adhere to his doctor's instructions and attend regular follow-up appointments.

Type 2 diabetes is a chronic metabolic disorder that necessitates regular medication for effective disease control. Abruptly stopping medication causes blood sugar to surge again, leading to numerous dangerous complications.

According to Doctor Tuyen, some individuals worry that long-term medication use may lead to dependence or harm the liver and kidneys. However, she emphasized that the risk of complications from uncontrolled diabetes is much higher. Patients should only reduce their dosage or stop medication after a thorough health assessment by a medical professional.

Doctors advise diabetic patients to adopt a bland diet, limiting sweets and fatty foods, and avoiding animal offal. Smoking must be avoided, and the use of other stimulants, such as: alcohol, beer, and coffee, should be minimized. Patients should prioritize a diet rich in vitamins and fiber, especially: plenty of green vegetables and fresh fruits. Regular physical activity, at least 30 minutes daily, is also crucial.

Bach Duong

*Patient's name has been changed*