Diabetes and stroke: Joining the warning dots
"There are several pathophysiological mechanisms wherein diabetes leads to ischemic stroke, including large artery atherosclerosis, cerebral SVD, and cardiac embolism. Not only is the presence of diabetes associated with an increased risk of stroke, but also post-stroke outcomes are generally worse in people with diabetes than in those without diabetes," the review study adds.
The study has been done by researchers from the Department of Endocrinology and Metabolism, Hadassah Medical Center, Jerusalem, Israel; Hebrew University of Jerusalem; University of Toronto; MayoClinic and University of L’Aquila.
How does diabetes lead to stroke?
High blood sugar stiffens the blood vessels which over time leads to fatty deposits or clots in the blood vessels.
The clots narrow down the blood vessels and cut off blood supply to main organs like the brain and hence cause stroke.
In people with diabetes the risk of stroke is two times more than others
Diabetes is a highly prevalent disease and is often associated with cardiometabolic risk factors which increases the risk of stroke.
Also in case of those with diabetes the post-stroke condition worsens and there is a greater risk for recurrence of stroke, studies have found.
Number of people with diabetes is increasing
As per the estimates of the International Diabetes Federation, currently 537 million adults are living with diabetes; this figure, which is already in an alarming state, is expected to grow to 643 million by 2030 and 783 million by 2045.
Diabetes is associated with a higher risk of hemorrhagic stroke and ischemic stroke.
As per studies the risk of ischemic stroke increases by 3% each year and triples in those who have had diabetes for ≥10 years, compared with those without diabetes.
Hyperglycemia or the condition where blood glucose level >6.0 mmol/L (108 mg/dL) was reported in up to two-thirds of all ischemic stroke subtypes upon hospital admission, the review study found.
The three common issues that link diabetes and stroke
Diabetes plays an active role in influencing three common causes of stroke: large artery atherosclerosis, cerebral small vessel disease (SVD), and cardiac embolism.
Large artery atherosclerosis, a leading cause of stroke, is accelerated by the physiological changes caused due to dyslipidemia, hyperglycemia, and insulin resistance.
Cerebral microvascular dysfunction, which is commonly seen in people with diabetes, makes a person prone to lacunar and hemorrhagic strokes.
Those with diabetes have a 35% higher risk of atrial fibrillation, a known and potential cause of cardiometabolic stroke.
Other risk factors for stroke
Apart from diabetes, the other risk factors for stroke are excessive belly fat which means when the waist size is more than 35 inches in women and 40 inches in men, high blood pressure, pre-diabetes condition, high cholesterol and tobacco consumption.
How to lower the risk of stroke if you have diabetes?
If you have diabetes then it is ideal to adopt a healthy lifestyle so that you can prevent the risk of stroke.
"Lower your risk by keeping your blood glucose, blood pressure, and cholesterol on target with healthy eating, physical activity, and, if needed, medicine. And if you smoke, quit. Every step you take will help. The closer your numbers are to your targets, the better your chances of preventing a stroke," the American Diabetes Association recommends.
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