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Diabetes and ischaemic stroke outcome.

E L MacDougal1, W H Herman1,2, J J Wing1

  • 1Department of Epidemiology, University of Michigan, Ann Arbor, MI, USA.

Diabetic Medicine : a Journal of the British Diabetic Association
|May 11, 2018
PubMed
Summary
This summary is machine-generated.

Diabetes increases mortality risk after ischemic stroke but does not affect stroke recurrence. Interventions are crucial, especially for Mexican-American individuals, to mitigate adverse outcomes.

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Area of Science:

  • Neurology
  • Endocrinology
  • Public Health

Background:

  • Diabetes is a prevalent comorbidity affecting stroke outcomes.
  • Understanding the impact of diabetes on post-stroke mortality, recurrence, and function is critical for patient management.

Purpose of the Study:

  • To compare all-cause mortality, stroke recurrence, and functional outcomes in ischemic stroke survivors with and without diabetes.
  • To investigate the influence of diabetes on post-stroke recovery and survival.

Main Methods:

  • A population-based cohort study of ischemic strokes in Nueces County, Texas (2006-2012).
  • Utilized Cox models to estimate mortality and stroke recurrence risks at 30 days and 1 year.
  • Employed Tobit regression to assess 90-day functional outcomes (Activities of Daily Living/Instrumental Activities of Daily Living scores).

Main Results:

  • 46% of 1301 ischemic stroke patients had a history of diabetes; 61% were Mexican American.
  • Adjusted analysis revealed diabetes predicted higher 1-year mortality (HR 1.47, 95% CI 1.09-1.97) but not stroke recurrence (1-year HR 1.27, 95% CI 0.78-2.07).
  • Diabetes was initially associated with worse functional outcomes, but this was explained by cardiovascular and pre-stroke factors; no significant association remained in the fully adjusted model.

Conclusions:

  • Diabetes is linked to increased mortality risk following ischemic stroke.
  • While not associated with stroke recurrence, diabetes necessitates targeted interventions to improve outcomes, particularly in the Mexican-American population.