Diabetes and ischaemic stroke outcome.

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.