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Comparative evaluation of diabetic and non-diabetic stroke--effect of glycaemia on outcome

R N Sarkar1, Samar Banerjee, A Basu

  • 1Department of Medicine, Medical College, Kolkata 700 073.

Journal of the Indian Medical Association
|May 13, 2005
PubMed

Insights

Diabetic stroke patients are younger and have a higher risk of transient ischemic attacks and ischemic strokes. Poor glycemic control in diabetics significantly increases stroke mortality, highlighting the need for better diabetes management.

Area of Science:

  • Neurology
  • Endocrinology
  • Cardiology

Background:

  • Extensive data exist on diabetic complications like retinopathy and neuropathy, but limited information is available on diabetic stroke.
  • Stroke is a significant cause of morbidity and mortality, and diabetes is a known risk factor.

Purpose of the Study:

  • To evaluate the distinctive features of stroke in diabetic versus non-diabetic individuals.
  • To compare early mortality rates between diabetic and non-diabetic stroke patients.

Main Methods:

  • A comparative study of 450 consecutive stroke cases, divided into known diabetics (Group I) and non-diabetics (Group II).
  • Clinical evaluation, assessment of target organ damage, glycaemic parameters (FPG, RPG, HbA1c), lipid profile, and CT scans were performed.
  • Risk factors such as hypertension and hypercholesterolemia were analyzed.

Main Results:

  • Diabetic stroke patients were younger (average age 51.2 vs. 67 years), with a higher incidence of previous stroke and transient ischemic attack (TIA).
  • Hypertension and hypercholesterolemia were more prevalent in diabetic stroke patients. Ischemic strokes and lacunar infarcts were more common in diabetics, while hemorrhagic strokes were more frequent in non-diabetics.
  • Four-week mortality was significantly higher in diabetic patients, particularly for ischemic stroke (26.3% vs. 14.8%) and hemorrhagic stroke (55.8% vs. 49.6%). High HbA1c levels were associated with increased mortality in diabetic stroke patients.

Conclusions:

  • Diabetic stroke presents with distinct characteristics, including younger age, higher TIA incidence, and increased risk of ischemic and lacunar strokes.
  • Hypertension and lipid abnormalities are significant risk factors contributing to increased stroke risk in diabetics.
  • Elevated mortality rates in diabetic stroke patients, especially with poor glycemic control, underscore the critical need for aggressive diabetes management and stroke prevention strategies.

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