Diabetes as a Risk Factor of Ischemic Stroke

Abstract

Background. Diabetes mellitus and stroke is a disease with a high prevalence and high rates of mortality.
Aim. Aim of this study is to analyze the risk factors of ischemic stroke in patients with diabetes and non-diabetic ones and glucose concentrations to determine the effect on the prognosis in these patients.
Material and methods. The study included 299 people with a history of ischemic stroke, including 21.5% of diagnosed and treated diabetes and 78.5% without diagnosed diabetes who were hospitalized in 2010 in the Department of Neurology, University Hospital in Bialystok. Retrospective analysis of medical records.
Results. Diabetes was present in 59.4% women and 21.4% of men (NS). The mean age of patients with diabetes and ischemic stroke was 74.62±11.89 years, and non-diabetic 73.56±10.13 years (NS). Hypertension was present among 80.4% of patients with ischemic stroke without diabetes and 92.2% with diabetes (p<0.001). Atrial fibrillation occurred in 40.4% of patients with ischemic stroke without diabetes and in 46.9% of ischemic stroke, and diabetes (NS). Triglycerides in patients with ischemic stroke and diabetes were on average 133.1±78.24 mg/dl and was significantly higher than in patients with ischemic stroke without diabetes (110.51±40.14 mg/dl) (p<0.05). HDL cholesterol in patients with ischemic stroke without diabetes were on average 44.10±13.66 mg/dl and was significantly higher than in patients with ischemic stroke, and diabetes (40.17±11.72 mg/dl) (p<0.05). Carotid stenosis was found in 14.9% of patients with ischemic stroke without diabetes and 29.7% of ischemic stroke, and diabetes (p<0.001). The mean concentration of glucose in patients with ischemic stroke and diabetes and circadian profile of fasting plasma glucose was 198.65±66.41 mg/dl and non-diabetic 164.70±77.84 mg/dl (p<0.005). Mean fasting glucose from the last measurement before discharge plasma glucose in patients with ischemic stroke, and diabetes was on average 158.16±40.26 mg/dl and non-diabetic 134.59±32.49 (p<0.001). Length of hospitalization of patients with ischemic stroke, and diabetes was on average 17.77±10.95 days and was significantly longer than patients with ischemic stroke without diabetes (15.05±11.54 days) (p<0.001). Death occurred in 9.4% of patients with ischemic stroke and diabetes, and 8.9% without diabetes (NS).
Conclusions: 1. The most common risk factors in patients with ischemic stroke were hypertension, diabetes, atrial fibrillation. While patients with diabetes and ischemic stroke were hypertension, carotid stenosis and elevated triglycerides. 2. Plasma glucose at admission on the first and last measurement of fasting was significantly higher in patients with ischemic stroke and concomitant diabetes and in those who died. 3. The prognosis in patients with ischemic stroke, and diabetes was significantly worse (longer duration of hospitalization, a higher proportion of deaths) compared to patients without diabetes. (PNN 2012;1(4):136-143)