Diabetes and stroke

Diabetes mellitus is a well-established independent risk factor for stroke and is associated with high mortality. Risk factors or risk markers for a first stroke were classified according to their potential for modification (nonmodifiable, modifiable, or potentially modifiable) and strength of evidence (well documented or less well documented). Modifiable risk factors include hypertension, exposure to cigarette smoke, diabetes, atrial fibrillation and certain other cardiac conditions, dyslipidemia, carotid artery stenosis, sickle cell disease, postmenopausal hormone therapy, poor diet, physical inactivity, and obesity and body fat distribution. Some of parameters are usefull as screening test to predict the incidence of stroke in diabetic patients in the future, such as UKPDS Risk Engine, incidence of carotid bruit featuring the stenosis of carotid artery, QTc interval prolongation and proteinuria. The real action must be taken to prevent the stroke when high risk patient is found. The modifiable and potentially modifiable risk factors that have been recommended by numbers of expert committee have to be modified immediately. In case with stenosis of carotid artery, the endarterectomy and carotid stenting have become popular and acceptable treatment in USA and Europe. It must be considered by Indonesian physicians to decrease the incidence of stroke.