Diabetes and Stroke: What Are the Connections?
Stroke is a major cause of death and long-term disability worldwide. Diabetes is associated with an increased risk of cardiovascular complications, including stroke. People with diabetes have a 1.5–2 times higher risk of stroke compared with people without diabetes, with risk increasing with diabete...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Korean Stroke Society
2023-01-01
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| Series: | Journal of Stroke |
| Subjects: | |
| Online Access: | http://www.j-stroke.org/upload/pdf/jos-2022-02306.pdf |
| _version_ | 1811171014202097664 |
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| author | Ofri Mosenzon Alice YY Cheng Alejandro A. Rabinstein Simona Sacco |
| author_facet | Ofri Mosenzon Alice YY Cheng Alejandro A. Rabinstein Simona Sacco |
| author_sort | Ofri Mosenzon |
| collection | DOAJ |
| description | Stroke is a major cause of death and long-term disability worldwide. Diabetes is associated with an increased risk of cardiovascular complications, including stroke. People with diabetes have a 1.5–2 times higher risk of stroke compared with people without diabetes, with risk increasing with diabetes duration. These risks may also differ according to sex, with a greater risk observed among women versus men. Several mechanisms associated with diabetes lead to stroke, including large artery atherosclerosis, cerebral small vessel disease, and cardiac embolism. Hyperglycemia confers increased risk for worse outcomes in people presenting with acute ischemic stroke, compared with people with normal glycemia. Moreover, people with diabetes may have poorer post-stroke outcomes and higher risk of stroke recurrence than those without diabetes. Appropriate management of diabetes and other vascular risk factors may improve stroke outcomes and reduce the risk for recurrent stroke. Secondary stroke prevention guidelines recommend screening for diabetes following a stroke. The diabetes medications pioglitazone and glucagon-like peptide-1 receptor agonists have demonstrated protection against stroke in randomized controlled trials; this protective effect is believed to be independent of glycemic control. Neurologists are often involved in the management of modifiable risk factors for stroke (including hypertension, hyperlipidemia, and atrial fibrillation), but less often in the direct management of diabetes. This review provides an overview of the relationships between diabetes and stroke, including epidemiology, pathophysiology, post-stroke outcomes, and treatments for people with stroke and diabetes. This should aid neurologists in diabetes-related decision-making when treating people with acute or recurrent stroke. |
| first_indexed | 2024-04-10T17:06:26Z |
| format | Article |
| id | doaj.art-9f949d1459a247f9a40e2aa6cf7d5157 |
| institution | Directory Open Access Journal |
| issn | 2287-6391 2287-6405 |
| language | English |
| last_indexed | 2024-04-10T17:06:26Z |
| publishDate | 2023-01-01 |
| publisher | Korean Stroke Society |
| record_format | Article |
| series | Journal of Stroke |
| spelling | doaj.art-9f949d1459a247f9a40e2aa6cf7d51572023-02-06T04:21:23ZengKorean Stroke SocietyJournal of Stroke2287-63912287-64052023-01-01251263810.5853/jos.2022.02306461Diabetes and Stroke: What Are the Connections?Ofri Mosenzon0Alice YY Cheng1Alejandro A. Rabinstein2Simona Sacco3 Diabetes Unit, Department of Endocrinology and Metabolism, Hadassah Medical Center, Jerusalem, Israel Department of Medicine, Division of Endocrinology and Metabolism, University of Toronto, Toronto, ON, Canada Division of Neurology, Mayo Clinic, Rochester, MN, USA Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, L’Aquila, ItalyStroke is a major cause of death and long-term disability worldwide. Diabetes is associated with an increased risk of cardiovascular complications, including stroke. People with diabetes have a 1.5–2 times higher risk of stroke compared with people without diabetes, with risk increasing with diabetes duration. These risks may also differ according to sex, with a greater risk observed among women versus men. Several mechanisms associated with diabetes lead to stroke, including large artery atherosclerosis, cerebral small vessel disease, and cardiac embolism. Hyperglycemia confers increased risk for worse outcomes in people presenting with acute ischemic stroke, compared with people with normal glycemia. Moreover, people with diabetes may have poorer post-stroke outcomes and higher risk of stroke recurrence than those without diabetes. Appropriate management of diabetes and other vascular risk factors may improve stroke outcomes and reduce the risk for recurrent stroke. Secondary stroke prevention guidelines recommend screening for diabetes following a stroke. The diabetes medications pioglitazone and glucagon-like peptide-1 receptor agonists have demonstrated protection against stroke in randomized controlled trials; this protective effect is believed to be independent of glycemic control. Neurologists are often involved in the management of modifiable risk factors for stroke (including hypertension, hyperlipidemia, and atrial fibrillation), but less often in the direct management of diabetes. This review provides an overview of the relationships between diabetes and stroke, including epidemiology, pathophysiology, post-stroke outcomes, and treatments for people with stroke and diabetes. This should aid neurologists in diabetes-related decision-making when treating people with acute or recurrent stroke.http://www.j-stroke.org/upload/pdf/jos-2022-02306.pdfdiabetes mellitushyperglycemiaoutcome assessmentriskstroke |
| spellingShingle | Ofri Mosenzon Alice YY Cheng Alejandro A. Rabinstein Simona Sacco Diabetes and Stroke: What Are the Connections? Journal of Stroke diabetes mellitus hyperglycemia outcome assessment risk stroke |
| title | Diabetes and Stroke: What Are the Connections? |
| title_full | Diabetes and Stroke: What Are the Connections? |
| title_fullStr | Diabetes and Stroke: What Are the Connections? |
| title_full_unstemmed | Diabetes and Stroke: What Are the Connections? |
| title_short | Diabetes and Stroke: What Are the Connections? |
| title_sort | diabetes and stroke what are the connections |
| topic | diabetes mellitus hyperglycemia outcome assessment risk stroke |
| url | http://www.j-stroke.org/upload/pdf/jos-2022-02306.pdf |
| work_keys_str_mv | AT ofrimosenzon diabetesandstrokewhataretheconnections AT aliceyycheng diabetesandstrokewhataretheconnections AT alejandroarabinstein diabetesandstrokewhataretheconnections AT simonasacco diabetesandstrokewhataretheconnections |